Neonatal Resuscitation

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Neonatal Resuscitation

• Mary P. Martinasek, BS, RRT
• Director of Clinical Education
• Hillsborough Community College

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Asphyxia

• May lead to irreversible brain damage
• The necessity to resuscitate is related to the
  degree of asphyxia

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Causes of fetal asphyxia
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Primary vs. Secondary Apnea

• Primary
• Initial asphyxia
• Signs

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Secondary Apnea

• If no resuscitation and apnea continues
• Signs

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Effects of asphyxia on the lungs

• Ineffective respirations cannot open alveoli
• Pulmonary Hypertension
• Pulmonary vasoconstriction

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Persistent Fetal Circulation

• Leads to further asphyxia
• Blood shunted
• CO2 remains high despite ventilation

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Preparation for Resuscitation
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Purpose of Resuscitation
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ABCs of Resuscitation

• A Establish an open airway
• B initiate breathing

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Resuscitation

• C Maintain circulation

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Initial steps

• Dry the infant
• Warm the infant
• Position the infant
• Suction the infant
• Stimulate the infant

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Next step

• Evaluate respirations
• If none or gasping , provide PPV with 100 O2 for
  15-30 seconds
• If spontaneous respirations then evaluate HR

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Next

• After 15-30 seconds of PPV or evaluation of
  spontaneous respirations then
• If HR is above 100 then reevaluate respirations
  and color
• If HR is less than 60 continue/start PPV and
  start compressions

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Reassess

• After 30 seconds reassess
• HR greater than 60 stop compressions
• HR greater than 100 and breathing stop PPV
• Evaluate infants color

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Thermoregulation

• Maintain a neutral thermal environment
• Possible causes of heat loss