Week 16: Newborn Life Support
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What is included in the rapid assessment of the newborn?
• colour • tone • breathing rate • heart rate • temperature
How long should you fry a baby for?
• 60 seconds • if less than 32 weeks, place in a plastic bag • 32-37 weeks gently dry not 30 seconds
How do you know if baby has a clear airway?
If it is crying
What should you do if baby is not breathing?
• confirm airway is open • place head a in neutral position • use transwarmer matters • suction no necessary, unless visible mucous or blood that cant be removed manually.
How should you suction a baby if necessary?
• low pressure • neer lose sight of tip of catheter • use light
How should you listen to a babies breathing in noisy or cold environments
Palpating a pulse at the umbilical cord can be an alternative but only reliable if HR is above 100bpm
Where should you attach a pulse oximeter?
The right wrist will give an accurate HR, in approximately 90 seconds and provides oxygen saturation
What is the first sign of clinical improvement on a baby?
An increased HR
How often should you reassess breathing and HR?
Every 30 seconds
If rapid transport to hospital required, what should you ensure?
• pre alert • heaters are on max
When should you take a temperature ?
At the earliest point, axilla thermometer only
What should you do if baby is not breathing adequately?
Give 5 inflation breaths sustaining the inflation pressure at about 30cm of water for 2-3 seconds with each breath- use 500ml BVM
If HR increases after inflation breaths, what should you expect?
That inflation breaths have been successful
What should you do if heart rate increases but the baby doesn’t breathe?
Ventilate at a rate of 30-40bpm until baby breaths on their own
What should you do if heart rate does not increase after inflation breaths?
Repeat 5 inflation breaths
What should you do after 5 repeated inflation breaths ?
Provide 20 seconds of ventilation breaths (1 every other second)
What should you do if heart rate remains less than 60bpm or is absent? (despite ruse ans all of chest fall)
Commence CPR ensuring the baby is on a flat surface (transwarmer mattress is acceptable)
How do you perform CPR on a newborn?
Encircle lower chest with both hands where the two thumbs can compress the lower third of the sternum , at a point just below an imaginary line joining the nipples, with fingers over the spine at the back - press quickly and firmly - ration 3:1
What should you do if baby doesn’t respond to BVM and CPR?
Time critical transfer, pre alert to nearest ED with obstetric unit
What is the best way to monitor a newborn?
Oxygen sats probe on the right hand
What should you do if a baby Is born with thick meconium and is responsive at birth?
The oropharynx must be inspected and cleared of meconium first, the focus should be on be on inflating the lungs and trachea should only be suctioned if a suitable largynoscope and competence
When should you introduce oxygen?
If O2 stats are not meeting the pre ductal sats at the times stated on the algorithm
What type of event is birth?
A hypoxic event for babies