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NEONATAL RESUSCITATION - Coggle Diagram
NEONATAL RESUSCITATION
1. Definition & Purpose
-Interventions to establish
breathing
and
circulation
at birth.
-Goal
: Identify at-risk infants, prepare equipment, and follow algorithm.
2. Key Components (ABCD)
A: Airway (Initial steps: drying, positioning, suction).
B: Breathing (PPV if apnea/HR < 100).
C: Circulation (Chest compressions if HR < 60).
D: Drugs (Epinephrine/volume expansion if HR remains < 60).
3. Anticipation & Risk Factors
-Antepartum:
-Maternal diabetes, hypertension, infection, drug abuse, bleeding.
-Intrapartum:
-C-section, meconium, prolapsed cord, prematurity, prolonged labor.
4. Equipment Checklist
Warmth: Radiant warmer, plastic wrap (<32 weeks), warm towels.
Airway: Bulb syringe, suction catheters (80–100 mmHg).
PPV: Oxygen blender (21–30% for preterm), masks, laryngeal mask.
Monitoring: Pulse oximeter (right hand), ECG, stethoscope.
Drugs: Epinephrine (IV/ETT), normal saline for volume expansion.
5. Initial Assessment (3 Questions)
Term? Breathing/crying? Good tone?
Yes
: Routine care (delayed cord clamping, skin-to-skin).
No
: Start resuscitation (dry, stimulate, position, suction).
6. Resuscitation Steps
PPV (HR < 100/apnea):
-Rate: 40–60 breaths/min.
-Pressure: 20–25 cmH₂O (adjust for chest rise).
-
Corrective steps (MR. SOPA)
: Mask, Reposition, Suction, Open mouth, Pressure increase, Alternative airway.
Chest Compressions (HR < 60):
-Technique
: Two-thumb encircling (lower 1/3 sternum).
-Ratio
: 3:1 (90 compressions:30 breaths/min).
-Depth
: 1/3 chest diameter.
Epinephrine (HR < 60 after compressions):
-IV
: 0.01–0.03 mg/kg (1:10,000).
-ETT
: 0.05–0.1 mg/kg (if no IV access).
8. Special Considerations
Preterm (<35 weeks):
-Lower PPV pressure (max 30 cmH₂O).
-Plastic wrap/thermal mattress.
Meconium
: Suction only if non-vigorous.
9. Post-Resuscitation Care
Monitor HR, SpO₂, BP, glucose, temperature.
Therapeutic hypothermia
for HIE (≥36 weeks).
10. Documentation & Debrief
-Record interventions, HR, SpO₂, medications.
-Team debrief post-resuscitation.