Neonatal Resuscitation -ALS- RC 290

Golden Rule: Always Establish Airway and Ventilation Before Using ALS Procedures Apgar Scores: 7-10:Free flow O2 4-6: PPV with 100% FIO2 0-3: Intubate, PPV with 100% FIO2, ALS

Note which ones can be given down the ET Tube!

Sodium Bicarb: Dose with ABGs Bicarb Dose = [BE] x weight in kilograms 3 Give half of this dose or [BE] x weight in kilos 6 Remember, sodium bicarb will increase CO2 production, so an airway and ventilation must be established before giving this drug!

Hypoglycemia and Glucose Hypoglycemic if blood glucose < than 40 mg/dl Treatment: Initially a bolus of 200mg/kg of D10W (10% glucose in water) IV infusion of 4-8 mg/kg/min

Artificial Airways Indications (same as an adult): Relief of upper airway obstruction Facilitation of secretion removal Protection of the airway, eg prevent aspiration Facilitation of mechanical ventilation

Neonatal ET Tubes ID is 2.5mm, 3.0mm, 3.5mm, or 4.0 mm No cuff! Murphy hole helps maintain patency in case tip becomes occluded

Selecting the Proper Sized ET Tube

Intubation Procedure , and good Pox

Note: Use a straight blade as if it is curved.

Securing an ET Tube Each hospital does it differently

Suctioning: Hazards like an adult but infant is more susceptible Trauma Hypoxia Atelectasis Airway obstruction and increased W.O.B. Use only size 5 Fr or 8 Fr Arrhythmia Hypotension Infection

Suction Technique (using 2 people) Hyperinflate and hyperoxygenate by increasing rate

Time to rock and roll!