Neonatal resuscitation:

 

Basics:

Before getting involved

·     Check patient + monitors + surgical field

·     Ask assistant or second anaesthetist to watch mother

·     Call neonatal code blue

Pick role

·     Helper

·     Airway

Assessment

General:

·     Colour: blue or pink

·     Activity: limp or flailing

·     Noise: silence or crying

Specific:

·     Airway: meconium, patency

·     Breathing: yes or no

·     Circulation: HR <60, 60-100, >100

Resuscitation

Main things:

1.   Suction: only if meconium

2.   Rub vigorously

3.   IPPV if HR <100 (RR 40-60, 25/5cmH2O, room air at first)

4.   CPR if HR <60 (3:1 ratio, two thumbs)

If still no response:

·     Intubate: MAC 0, size = PMA/10, depth = weight + 6cm

·     Cannulate: umbilical vein (mouth of smiley face)

·     Drugs: adrenaline 10mcg/kg, atropine 30mcg/kg

·     Crystalloid: 20mL/kg

Targets

·     At 1 min: SpO2 60-70%

·     At 5 min: SpO2 80-90%

 

 

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