Be Still My Heart
How do you provide chest compressions in a neonate?
Two-thumb encircling technique or 2 finger technique
With which concentration of oxygen do you start a resuscitation in a term newborn?
0.21, or Room Air
A 2 week old infant arrives to the hospital with tachypnea and cyanosis. You hear a murmur on his cardiac exam. What tests can you do to evaluate for a cardiac etiology while you wait for the Cardiologist to do an echo?
Pre- and post-ductal sats, 4 extremity blood pressure, EKG, CXR
What is a side effect of prostaglandin?
Apnea
Correct concentration of epinephrine for neonatal concentration
1:10,000
When is it recommended to use an oxygen concentration of 1.0 in the delivery room?
When chest compressions are needed
A term male infant is born with gastroschisis. There are three interventions and one positional change that must be done in the delivery room.
1. Peripheral IV (to replace massive free water losses) 2. Plastic bag over the intestines (to reduce free water loss) 3. Replogle (to decompress the stomach and intestines)
4. Position - on the right side (to prevent constriction of the intestines from a narrow right-sided abdominal wall defect).
A preterm newborn is born to a mother with preeclampsia. The baby has low tone and required intubation in the delivery room because he did not improve with positive pressure ventilation. What is one possible reason for this baby's findings?
Maternal magnesium administration for seizure prevention (preeclampsia) and to delay labor.
Ratio of chest compressions to breaths
3:1 (one and two and three and breathe)
What is the starting PIP for providing positive pressure ventilation in preterm newborns?
20-25 cmH20
The mode of heat loss that is prevented by placing a premature infant on a heated mattress.
Conductive heat loss. Loss of heat from the infant to a solid surface.
What intervention can be given to a mother if she goes into pre-term labor to encourage rapid lung development in neonates?
Steroid administration
How do you measure pre- and post-ductal sats?
The saturation probe is applied to the baby's right hand (provides a pre-ductal reading) and either foot (provides a post-ductal reading)
An approximately 1.2kg 29 week infant is breathing spontaneously on mask CPAP with PEEP 5 in the delivery room, but saturations on FiO2 0.70 are 65% at 4 minutes. What is your next step?
Increase PEEP to 6
What is the threshold to intervene for hypoglycemia in an infant less than 24 hours old?
2.5 mmol/L for first 24 hours of life. After 48 hours, target is 3.3 mmol/L
How do you decide what size ET tube to use in a neonate? (uncuffed)
Gestational age / 10
A 27 week infant has a heart rate of 80 in the delivery room. He appears to weigh 1kg. What is your next step?
Positive-pressure ventilation
What can you try if a newly born baby has labored breathing, but not apnea or gasping?
CPAP
A 2 week old infant comes to the hospital and looks very jaundiced. The mother states he is feeding well with lots of urine diapers, but his stools are clay-colored. His direct bilirubin is elevated and you palpate a liver edge. What is a possible anatomic reason for these findings?
Biliary atresia
Why is a Miller blade preferred for neonatal intubation?
Straight blade lifts the omega-shaped, floppy epiglottis