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Neonatal Resuscitation Program

This document provides guidance on neonatal resuscitation through a reference chart. It outlines the key steps of the neonatal resuscitation program which are airway, breathing, circulation, and drugs. The most important action is ventilation of the baby's lungs through positive pressure ventilation if needed. It provides details on ventilation rates and targets for oxygen saturation at different time points. It also lists medications that may be used like epinephrine and volume expanders if the heart rate is below targets.

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Wilma Yandan Bau
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5K views1 page

Neonatal Resuscitation Program

This document provides guidance on neonatal resuscitation through a reference chart. It outlines the key steps of the neonatal resuscitation program which are airway, breathing, circulation, and drugs. The most important action is ventilation of the baby's lungs through positive pressure ventilation if needed. It provides details on ventilation rates and targets for oxygen saturation at different time points. It also lists medications that may be used like epinephrine and volume expanders if the heart rate is below targets.

Uploaded by

Wilma Yandan Bau
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Neonatal Resuscitation Program – Reference Chart

The most important and effective action in neonatal resuscitation is ventilation of the baby’s lungs.

Antenatal counseling. A. Airway


Team briefing and  Put baby’s head in “sniffing” position
equipment check  Suction mouth then nose
 Suction trachea if meconium-stained and Not vigorous

B. Breathing
Birth  PPV for apnea, grasping or pulse<100bpm
 Ventilate at rate of 40 to 60 breaths/minute
 Listen for rising heart rate, audible breath sounds
Stay with mother for routine care  Look for slight chest movement with for each breath
Warm and maintain normal  Attached a pulse oximeter
Term? Tone? Yes
temperature, position airway, clear
Breathing or crying C. Circulation
secretions if needed, dry ongoing
evaluation  Start compression if HR is <60 after 30 seconds of effective PPV
 Give (3 compressions: 1 breath) every 2 seconds
 Compress one third of the anterior-posterior diameter of the chest
No
Warm and maintain normal D. Drugs
temperature, position airway, clear  Give epinephrine if HR is <60 after 45 to 60 seconds of compressions and
secretions if needed, dry stimulate ventilation
 Caution: epinephrine dosage is different for ET and IV router

No Labored breathing or
Apnea, gasping or
HR below 100 bpm? persistent cyanosis? M Mask adjustment
or
R Reposition Airway
Yes Yes
PPV. Position and clear airway Spo2, S Suction mouth and nose
SPO2, monitor. monitor. Supplemental Ox,O2 as
Consider ECG monitor. needed consider CPAP O Open mouth

P Pressure increase
HR below 100 bpm? Post Resuscitation
care Team debriefing A Airway alternative
Yes Depth of
Gestational
Weight ET Tube Insertion
Age
Check chest movement. Pre-ductal Spo2 Target (weeks)
(kg.) (ID, mm) (cm from upper
Ventitalation corrective steps if lip)
needed.
ETT or laryngeal mask if needed 1 min 60% - 65% <28 <1.0 2.5 6–7

2 min 65% - 70%


No 28 - 34 1.0 - 2.0 3.0 7–8
3 min 70% - 75%
HR below 60 bpm? 4 min 75% - 80% 34 - 38 2.0 - 3.0 3.5 8–9
5 min 80% - 85%
Yes 10 min 85% - 90% >38 >3 3.5 – 4.00 9 - 10
Incubate if not already done. Chest
compressions Coordinate with PPV Medications Used During or Following Resuscitation of the Newborn
100% O2 ECG monitor.
Weight Total IV
Medication Dosage/Route Concentration Precautions
(kg) Volume(ml)
Intravenous (UVC preferred 1 1:10,000 0.1 - 0.3 Give rapidly,
route) 0.1 to 0.3 ml/kg 2 0.2 - 0.6 Repeat every 3 to 5 minutes
HR below 60 bpm? Higher IV does not 3 0.3 - 0.9 if HR <60 with chest
Epinephrine
recommended 4 0.4 - 1.2 compressions.
Yes Endotracheal 0.5 to 1 ml.kg

Volume 10ml/kg IV 1 10 Indicated for shock.


Expanders 2 20 Give over 5 to 10 minutes
IV epinephrine (If HR persistently Isotonic 3 30 Reassess after each bolus.
Crystalloid 4 40
below 60bpm consider hypovolemia
(normal saline)
consider pneumothorax. Or blood

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