Initial Steps
What are the initial steps of neonatal resuscitation?
Warm, Dry, Stimulate the baby
What device is used to provide positive pressure ventilation?
T-Peice or Bag-mask device
When should chest compressions be started?
When the heart rate is below 60 beats per minute after effective ventilation is established.
What is the first-line medication for neonatal resuscitation?
Epinephrine
What should be done if meconium is present and the baby is not vigorous?
Suction the airway before initiating positive pressure ventilation
What is the recommended initial oxygen concentration for term infants?
Room air (21% oxygen)
What is the correct position for the infant’s head during ventilation?
Slightly extended (sniffing position)
What is the correct compression-to-ventilation ratio?
3:1
What is the preferred route for administering epinephrine?
Umbilical (UVC) or intraosseous (IO)
How should resuscitation be modified for a preterm infant?
Use a polyethylene bag or wrap to prevent heat loss and covered heating pad
During the resuscitation of a newborn, you palpate the umbilical cord and count 10 beats over a 6 second period. What heart rate do you report to your team?
100
What is the recommended ventilation rate for a newborn?
40-60 breaths per minute
A baby requiring ventilation and chest compressions. After 60 seconds of chest compressions, the heart rate is 70bpm. What is your next step?
Stop chest compressions and continue PPV
What is the dose of IV/IO epinephrine for neonatal resuscitation?
0.02mg/kg or 0.2ml/kg
What is the recommended action if the baby has a pneumothorax?
Needle decompression or chest tube insertion
What is the target pre-ductal oxygen saturation at 5 minutes of life?
80-85%
What is the initial pressure that should be used during positive pressure ventilation?
20-25 cm H2O
What is the correct hand placement for performing chest compressions on a newborn?
Two thumbs encircling the chest, just below the nipple line
What is the recommended dose of normal saline for volume expansion in neonatal resuscitation?
10 mL/kg
How should resuscitation be modified for a baby with congenital diaphragmatic hernia?
Avoid bag-mask ventilation and intubate immediately
What is the recommended action if the baby is not breathing or has a heart rate below 100 beats per minute after initial steps?
Begin positive pressure ventilation (PPV)
What are the 2 indications for using an endotracheal tube or LMA during resuscitation?
If PPV ventilation is ineffective or if chest compressions are needed.
How often should you reassess the heart rate during chest compressions?
Every 60 seconds
What is the dose of ET epinephrine for neonatal resuscitation?
0.1mg/kg or 1ml/kg
What is the recommended action if the baby has persistent bradycardia despite effective ventilation and chest compressions?
Administer epinephrine and consider volume expansion