Neonatal Resuscitation

Front 1

Normal newborn vitals

Back 1

HR = 100 - 180
RR = 40 - 60
MAP should be equivalent to GA
target 02 sat by right UE = 85-95%
glucose > 2.22

Front 2

Newborns in whom resuscitation should be withheld

Back 2

GA < 23 weeks
Weight < 400g
Anencephaly, trisomy 13, or trisomy 18

Front 3

Infants with meconium stained fluid who should be considered for tracheal suctioning

Back 3

(1) absent or decreased respirations
(2) poor muscle tone
(3) HR < 100 bpm

Front 4

Resuscitation with diaphragmatic hernia

Back 4

Early intubation to prevent gastric insufflation leading to increased intra-thoracic pressure

Front 5

Neonatal resuscitation equipment sizing

Back 5

Front 6

MR SOPA for ventilatory troubleshooting during neonatal resuscitation

Back 6

Mask adjustment
Reposition head to open airway
Suction
Open mouth and lift jaw forward
Pressure increase (max 40cm H2O)
Airways control (ETT or LMA)

Front 7

Compression to ventilation ratio for NRP

Back 7

3:1 with 90 compressions/minute

Front 8

Targeted Preductal Sats after Birth

Back 8

Front 9

Equipment Needed for Neonatal Resuscitation

Back 9

1. Gown, gloves, and eye protection (universal precautions)
2. Blankets (to warm and dry infant)
3. Radiant warmer
4. Bulb syringe
5. Suction and suction catheters (French #5, #8, and #10)
6. Self-inflating bags (450 and 750 mL)
7. Masks (premature, newborn, and infant sizes)
8. Laryngoscope with straight blades (No. 00, 0, and 1)
9. Endotracheal tubes with stylets (2.5, 3.0, 3.5, and 4 mm)
10. Scissors and tape to stabilize endotracheal tube
11. CO2 detector
12. Meconium aspirator
13. Umbilical catheters (French #3.5 and #5)
14. Hemostats, sterile drapes and gloves, povidone-iodine solution, scalpel, umbilical tape, suture, and three-way stopcock for umbilical vessel catheterization

Front 10

Key maternal history questions for neonatal resucitation

Back 10

1. What is the estimated gestational age?
2. Is this a multiple gestation?
3. Is meconium present?
4. Is there a history of vaginal bleeding?
5. Were medications given or drugs taken?N

Front 11

NRP Algorithim

Back 11

Front 12

Infants who can be provided routine care

Back 12

(1) Term gestation

(2) Breathing/crying

(3) Good tone

Front 13

Routine Care

Back 13

Stay with mother

Provide Warmth

Suction if needed

Dy

Ongoing Evaluation

Front 14

Neonates who need PPV

Back 14

HR <100

Gasping

Apneic

Front 15

Neonates who need intubation/chest compressions/epinephrine

Back 15

HR <60

Front 16

Neonated who need CPAP

Back 16

HR >100 but larbored breathing or persistent cyanosis

Front 17

Apgar Scores

Back 17

Front 18

Neonatal resucitation drugs and dosages

Back 18