Resuscitation

Neonate Comin’ in Hot?

Been a minute since you did NRP?

A Summary of Neonatal Resuscitation

• Term, tone, crying? Yes – clamp & cut cord at 30-60 seconds, baby stays with mom
• Not term/poor tone/poor respiratory effort? Warm, dry, suction, stimulate
• Apnea/HR <100? Positive pressure ventilation (PPV) – Bag the baby! HR = count beats 6 seconds x 10.
• HR still <100? Optimize PPV – MR SOPA
  • Mask reposition, Reposition airway…give 5 breaths
  • Suction mouth then nares, Open mouth…give 5 breaths
  • Pressure increase to move the chest…give 5 breaths, definitive Airway (LMA/ETT)
• HR <60? ETT/LMA, chest compressions (CC) 3CC:1PPV, optimize ventilation, consider umbilical venous catheter (UVC – see video below)
• HR still <60? Give epinephrine 0.02mg/kg via UVC/IV/IO, consider NS 10mL/kg or PRBCs 10mL/kg over 5-10 min, consider tension PTX

Special thanks to Mary Lemley, Meghan Arms, Katie Judd, and the Neonatal Outreach Education and Training team, Monroe Carell Jr. Children’s Hospital at Vanderbilt Children’s Hospital, for helping with this video.

Acknowledgements:

• The full AHA NRP algorithm is found here.
• The umbilical cord picture was from Stanford University.
• Neonatal Outreach Education and Training team, Monroe Carell Jr. Children’s Hospital at Vanderbilt – more resources here.