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Neonatal Resuscitation

Neonatal Resuscitation. -ALS- RC 290. Golden Rule: Always Establish Airway and Ventilation Before Using ALS Procedures. Apgar Scores: 7-10:Free flow O2 4-6: PPV with 100% FIO2 0-3: Intubate, PPV with 100% FIO2, ALS. Note which ones can be given down the ET Tube!.

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Neonatal Resuscitation

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  1. Neonatal Resuscitation -ALS- RC 290

  2. Golden Rule: Always Establish Airway and Ventilation Before Using ALS Procedures Apgar Scores: • 7-10:Free flow O2 • 4-6: PPV with 100% FIO2 • 0-3: Intubate, PPV with 100% FIO2, ALS

  3. Note which ones can be given down the ET Tube!

  4. Sodium Bicarb: Dose with ABGs • Bicarb Dose = [BE] x weight in kilograms 3 • Give half of this dose or [BE] x weight in kilos 6 • Remember, sodium bicarb will increase CO2 production, so an airway and ventilation must be established before giving this drug!

  5. Hypoglycemia and Glucose • Hypoglycemic if blood glucose < than 40 mg/dl • Treatment: • Initially a bolus of 200mg/kg of D10W (10% glucose in water) • IV infusion of 4-8 mg/kg/min

  6. Artificial Airways Indications (same as an adult): • Relief of upper airway obstruction • Facilitation of secretion removal • Protection of the airway, eg prevent aspiration • Facilitation of mechanical ventilation

  7. Neonatal ET Tubes • ID is 2.5mm, 3.0mm, 3.5mm, or 4.0 mm • No cuff! • Murphy hole helps maintain patency in case tip becomes occluded

  8. Selecting the Proper Sized ET Tube

  9. Intubation Procedure , and good Pox

  10. Note: Use a straight blade as if it is curved.

  11. Securing an ET Tube Each hospital does it differently

  12. Trauma Hypoxia Atelectasis Airway obstruction and increased W.O.B. Use only size 5 Fr or 8 Fr Arrhythmia Hypotension Infection Suctioning: Hazards like an adult but infant is more susceptible

  13. Suction Technique (using 2 people) Hyperinflate and hyperoxygenate by increasing rate

  14. Time to rock and roll!

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