PRINCIPLES OF NEONATAL RESUSCITATION

INTRODUCTION

The success of the outcome of resuscitation depends greatly on the speed and effectiveness of initiating appropriate management.

Aim

To provide adequate resuscitation to ensure the survival of the neonate and prevention of morbidity.

A Airway

To establish and maintain airway by:

B Breathing

To establish and maintain respiratory effort for effective pulmonary gas exchange

C Circulation

Maintain heart rate and adequate perfusion.

D Drugs

E Equipment and Environment

F Followup

NEONATAL RESUSCITATION PROTOCOL

Checking and Preparation of Equipment

The most essential part of resuscitation is ensuring that all resuscitation equipment is in.good working order and ready for use at any time. Checking is necessary at the beginning of each shift and after use.

Equipment used:

Radiant Warmer

Suction

Air and Oxygen Supply

Check that cylinder supplies are adequate and flow-meters work correctly.

Laerdal Bag

lntubation Equipment

Resuscitation Drugs

RESUSCITATION PROCEDURE FOLLOWING DELIVERY

Keep warm and dry

Suctioning

Meconlum Aspiration:

Administration of Oxygen

N.B. CORRECT VENTILATION TECHNIQUE IS VITALLY IMPORTANT.

Face Mask Oxygen

Intubation

Indications

Assess infant's condition after intubation and proceed if indicated.

External Cardiac Massage

This is indicated if the heart rate is <80/minute and decreasing despite suctioning, oxygenation and ventilation.

Resuscitation Drugs

Drug tray should contain :

Management of the Neonate with the following Apgar Scores at One Minute

APGAR SCORE 10

APGAR SCORE 4-7

APGAR SCORE 0-3

N.B.: If neonate does not breath immediately commence resuscitation stat. Do not wait to assess 1 minute Apgar score.

Adapted from Box Hill Emergency Department Manual
27/9/2000 SLJ