Administrative
How many CEUs will you earn for the online-based portion of your NRP class?
What is 12 CEUs?
After completing the initial steps of the NRP algorhythm, PPV is indicated if the baby is demonstrating any one or more of these three things:
What is: apnea
gasping
HR <60
The Key factors to determine effective ventilation
What is chest rise,
equal bilateral breath sounds,
Positive color change to "yellow" on the exhaled CO2 cap,
rapidly rising heart rate
Chest compressions are indicated when
The HR remains <60 bpm after at least 30 seconds of PPV that inflates the lungs, as evidenced by chest movement with ventilation.
You are called to a delivery. When you enter the room the pre-birth questions you ask are:
What is the gestational age?
What is the color of the fluid?
What are the risk factors?
What is the plan for cord clamping?
How many CEUs will you earn for the classroom portion of this class
What is 2 CEUs?
During PPV, the initial Fi02 concentration for newborns > 35 weeks is _____, and for preterm newborns <35 weeks is_____.
What is: 21% Fi02, 21-30% Fi02
The appropriate depth of the ET tube is determined by these measurements
What is the nasal-tragus length (NTL)
measured by the distance from baby's nasal septum to the ear tragus + 1cm. Secure at baby's lip.
Landmarks to position hands for providing chest compressions
Thumbs on the center of the sternum just below an imaginary line connecting the baby's nipples. Not over the xyphoid.
You are attending a delivery for a baby who had a cord prolapse with fetal bradycardia in the last 3 minutes prior to birth. The rapid assessment evaluation you do at delivery includes these 3 questions:
Term?
Tone?
Breathing?
The single most important and effective step in neonatal resuscitation?
What is positive pressure ventilation?
The cadence (rhythm) for PPV?
What is "breath, two, three; breath, two, three..."
Baby's condition suddenly worsens after intubation. The mnemonic DOPE can be used to guide assessment as to the cause. DOPE stands for:
D-Displaced ETT
O-Obstructed ETT
P-Pneumothorax
E-Equipment failure
Compressions are coordinated with positive pressure ventilation by using this cadence (rhythm)
One and two and three and breathe and-
One and two and three and breathe and-
You are working the post-partum floor. You do a check on your 12 hour old newborn at 1 am. The lights are low in the room. It appears the infant is dusky and not breathing. What are your next steps?
1. Turn on light and assess baby
2. Initiate stimulation and call for help
3. Take ambu mask/bag and begin PPV until support arrives.
4. When co-worker arrives ask for assessment of effective PPV. Adjusts as necessary. Assess HR. Begin CC if indicted.
The percent of newborns who will receive positive pressure ventilation
What is 5%?
MR SOPA describes
What are the ventilation corrective steps
M-mask readjustment,
R-reposition head, neck,
S-suction mouth, nose.
O-open mouth,
P-pressure increase,
A-Alternate airway
When providing PPV with neopuff or Panda, the PIP should be _____ and the EEP should be____
PIP 20-25cm H2O
EEP 5-6cm H2O
The mnemonic CARDIO is a way to assess the baby when the HR is not improving with Compressions and Ventilation.
C-chest movement with each ventilation
A-airway is established with ETT or LMA and secure
R-Rate coordinated 3 compressions with 1 ventilation every 2 seconds
D- depth 1/3 the AP diameter of the chest
IO- inspired oxygen is 100%
You have been called to the emergent c-section delivery of a 3 kg term infant experiencing abruption. After the baby was born your team followed the algorithm of NRP. You are now providing PPV with coordinated CC. After 60 seconds, the provider requests epi via the ETT while a UVC line is being established. The appropriate dose in milliliters is:_____
Epinephrine Concentration: 0.1mg/ml = 1mg/10ml
ETT dose: 0.1mg/kg = 1ml/kg 3kg = 3ml
IV, IO (preferred) Dose: 0.02mg/kg = 0.2ml/kg 3kg = 0.6ml
Repeat every 3-5 minutes
The number of babies per 1000 births who will receive chest compressions or emergency medications?
What is 1-3 babies per 1000 births?
The most important indicator of effective PPV
What is a rising heart rate
A baby is 4 minutes old and is crying. Oxygen saturation is only 75% on the right wrist. Your next step is:
Continue monitoring. The normal SaO2 for a baby at 4 minutes of age is 75-80% based on the Target Oxygen Saturation Table.
Indications to stop chest compressions
HR >60 or greater
You are at the delivery of a 3 kg infant who experienced significant blood loss during abruption. You have provided PPV, CC and epi via ETT and one dose via UVC line. There is little improvement in heart rate. The provider requests O negative PRBCs or NS (which ever is available first). What is the dose and how much will you draw up?
For fluid resuscitation: 10ml/kg NS or O neg PRBCs
3kg = 30ml
give over 5-10 minutes in UVC