Download Neonatal Resuscitation

Neonatal Resuscitation
-ALSRC 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!
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!
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
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
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
Selecting the Proper Sized ET Tube
Intubation Procedure
, and good Pox
Note: Use a straight blade as if it is curved.
Securing an ET Tube
Each hospital does it differently
Suctioning: Hazards like an adult
but infant is more susceptible
•
•
•
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Trauma
Hypoxia
Atelectasis
Airway obstruction and
increased W.O.B.
– Use only size 5 Fr or 8 Fr
• Arrhythmia
• Hypotension
• Infection
Suction Technique (using 2 people)
Hyperinflate and hyperoxygenate by increasing rate
Time to rock and roll!