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RDS (Treatment and nursing care (Initial labor room (delay cord clamp,…

- - - - Transcutaneous CO2 monitor (TCM) or end tidal CO2 monitor (etCO2) if appropriate
      - Surfactant
      - Continuous cardiovascular monitoring equipment
      - Size 5 Fr feeding tube
      - 3ml or 5ml syringe (dose dependent)
      - Large gauge needle (18g, 19g or 20g)
      - Alcohol swab 70%
      - Tape measure
      - Sterile scissors
      - Emergency equipment: Neopuff and mask, suction
    - - Ensure and confirm correct position of the endotracheal tube (ETT) via chest x-ray prior to giving surfactant
      - Record baseline observations: heart rate, respiration rate, oxygen saturation, etCO2, plus a blood gas if required
      - Ensure patency of ETT. Suction ETT before administration
      - Slowly warm the vial of surfactant to room temperature before administration
      - Administering medical practitioner performs hand hygiene and dons sterile gloves.
      - cut a sterile 5 fg feeding tube to the length so that the tip lies 1 cm above the end of the endotracheal tube
      - Slowly withdraw a little over the required dose into a 3 or 5 mL plastic syringe using a large-gauge needle
      - Ensure bed is flat. Place the neonate in supine position
      - Assistant disconnects the ETT from the ventilator
      - Dr. to administer the surfactant via the pre-cut 5 Fr catheter in a single bolus dose as quickly as the neonate tolerates
      - Reconnect ETT to ventilator as soon as possible. If neonate was on CPAP, positive pressure ventilation is given via the Neopuff
      - Ventilator support or inspired oxygen may need to be temporarily increased.
    - - เสียงต่อภาวะพร่องออกซิเจนเนื่องจากอุดกั้นทางเดินหายใจ
        
        desaturation and ETT blockage (Suction หลังให้Surfactant 6 ชม)
      - เฝ้าระวังPneumothorax
        
        if ventilation settings are not appropriately changed
        
        Vte ที่เพิ่มขึ้น>8ml/kg
      - Pulmonary haemorrhage
        
        Ensure the PEEP remains above 5cm H2O
        
        เฝ้าระวังภาวะเลือดออกในปอด
  - - - non-invasive ventilator
      - invasive ventilator