Topic: Immunization, Baby friendly hospital, congenital cyanotic heart disease
Question: Describe with the help of a flow chart steps in neonatal resucitation.
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steps in neonatal resuscitation in detail:
- Dry and stimulate the baby: Wipe away any fluid on the body and stimulate by rubbing the back. This helps in transition from intrauterine to extrauterine life.
- Clear airway if needed: Suction the mouth and then nose gently with a bulb syringe if there is meconium or secretions present.
- Evaluate breathing: Observe chest rise for breathing efforts in the first 30 seconds. Look for other signs like crying, movement, and heart rate above 100/min.
- Provide warmth: For depressed babies, warm the baby by placing under a radiant heater or wrapping in warm/dry towels/blankets after drying.
- Initiate PPV if not breathing: Use bag and mask with room air at an inflation pressure of 20-30 cmH2O to deliver breaths at a rate of 40-60/min in 1-second inflation followed by passive expiration.
- Reassess every 30 seconds: Check HR, color, tone. If HR remains below 100/min despite effective PPV, initiate chest compressions.
- Chest compressions: Deliver compressions at a 3:1 ratio with compressions and ventilations at a rate of 120/min using 2 fingers on the lower third of sternum.
- Reassess every 60 seconds: Check HR, O2 saturation. If still below 100/min administer IV epinephrine/volume expansion.
- Continue support and monitor vital parameters closely.
- Prevent heat loss. Maintain temperature of 36.5-37.5°C.
- Consider NICU referral if apnea/bradycardia, respiratory distress or other complications.
- Discuss with pediatrician for further care.
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