Neonatal Resuscitation is intervention after a baby is born to help it breathe and to help its heart beat. Neonatal resuscitation skills are essential for all health care providers who are involved in the delivery of newborns. Globally, about one quarter of all neonatal deaths are caused by birth asphyxia. Birth asphyxia is defined simply as the failure to initiate and sustain breathing at birth. Effective resuscitation at birth can prevent a large proportion of these deaths.
Key Messages
1. Effective ventilation is the key to successful resuscitation.
2. The need for neonatal resuscitation at birth cannot always be anticipated or predicted.
3. At every birth, no matter how ‘low risk’, suitable equipment and staff must be available and prepared to resuscitate the newborn infant.
4. 10% of newborns require resuscitation.
5. Newborn resuscitation is a critical skill that requires constant practice.
Related Article :
- Three Stages Of Labor
- Guidelines for Diagnostic Imaging During Pregnancy
- Crying Cat Syndrome (Cri-du-Chat)
Neonatal Advanced Life Support (NALS): Neonatal Algorithm
Time: 0-30 seconds
1. Initial evaluation :
- Term gestation?
- Breathing or crying?
- Good muscle tone?
2. Routine care if initial evaluation findings are normal :
- Provide warmth
- Clear airway if necessary
- Dry newborn
- Ongoing evaluation
3. Measures if initial evaluations findings are abnormal :
- Provide warmth
- Clear airway if necessary
- Dry, stimulate, and reposition
Time: 30-60 seconds
4. Secondary evaluation :
- Respirations
- Heart rate
- Color
5. If the heart rate is >100 bpm and the baby is pink with nonlabored breathing, proceed with routine care.
6. If the heart rate is >100 bpm and the baby is cyanotic or has labored breathing, follow the steps below :
- Clear airway and begin monitoring pulse oximetry oxygen saturation (SpO2)
- Consider supplementary oxygen
- Consider continuous positive airway pressure (CPAP)
- If the baby improves, institute postresuscitation care
7. If the heart rate is < 100 bpm and the baby is gasping or apneic, follow the steps below :
- Clear airway and begin SpO2 monitoring
- Provide positive-pressure ventilation
- Consider supplementary oxygen
- If the baby improves, institute postresuscitation care
Time: 60-90 seconds
8. If the heart rate is < 60 bpm, follow the steps below :
- Start chest compressions
- Consider intubation; intubate if no chest rise
9. Reassess heart rate :
- If the heart rate is >60 bpm, stop compressions and continue ventilation
- If the heart rate is < 60 bpm, administer epinephrine and/or volume expansion.
References
1. MedScape : NALS - Neonatal Resuscitation
http://emedicine.medscape.com/article/2172079-overview
2. WHO : Basic Newborn Resuscitation (2012).
Related Article :
- Three Stages Of Labor
- Guidelines for Diagnostic Imaging During Pregnancy
- Crying Cat Syndrome (Cri-du-Chat)
Key Messages
1. Effective ventilation is the key to successful resuscitation.
2. The need for neonatal resuscitation at birth cannot always be anticipated or predicted.
3. At every birth, no matter how ‘low risk’, suitable equipment and staff must be available and prepared to resuscitate the newborn infant.
4. 10% of newborns require resuscitation.
5. Newborn resuscitation is a critical skill that requires constant practice.
Related Article :
- Three Stages Of Labor
- Guidelines for Diagnostic Imaging During Pregnancy
- Crying Cat Syndrome (Cri-du-Chat)
Neonatal Advanced Life Support (NALS): Neonatal Algorithm
Time: 0-30 seconds
1. Initial evaluation :
- Term gestation?
- Breathing or crying?
- Good muscle tone?
2. Routine care if initial evaluation findings are normal :
- Provide warmth
- Clear airway if necessary
- Dry newborn
- Ongoing evaluation
3. Measures if initial evaluations findings are abnormal :
- Provide warmth
- Clear airway if necessary
- Dry, stimulate, and reposition
Time: 30-60 seconds
4. Secondary evaluation :
- Respirations
- Heart rate
- Color
5. If the heart rate is >100 bpm and the baby is pink with nonlabored breathing, proceed with routine care.
6. If the heart rate is >100 bpm and the baby is cyanotic or has labored breathing, follow the steps below :
- Clear airway and begin monitoring pulse oximetry oxygen saturation (SpO2)
- Consider supplementary oxygen
- Consider continuous positive airway pressure (CPAP)
- If the baby improves, institute postresuscitation care
7. If the heart rate is < 100 bpm and the baby is gasping or apneic, follow the steps below :
- Clear airway and begin SpO2 monitoring
- Provide positive-pressure ventilation
- Consider supplementary oxygen
- If the baby improves, institute postresuscitation care
Time: 60-90 seconds
8. If the heart rate is < 60 bpm, follow the steps below :
- Start chest compressions
- Consider intubation; intubate if no chest rise
9. Reassess heart rate :
- If the heart rate is >60 bpm, stop compressions and continue ventilation
- If the heart rate is < 60 bpm, administer epinephrine and/or volume expansion.
References
1. MedScape : NALS - Neonatal Resuscitation
http://emedicine.medscape.com/article/2172079-overview
2. WHO : Basic Newborn Resuscitation (2012).
Related Article :
- Three Stages Of Labor
- Guidelines for Diagnostic Imaging During Pregnancy
- Crying Cat Syndrome (Cri-du-Chat)
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