1. Neonatal Resuscitation
-ALS-
RC 290

2. 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

4. Note which ones can be given down the ET Tube!

5. 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!

6. 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

7. 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

8. 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

9. Selecting the Proper Sized ET Tube

10. Intubation Procedure
, and good Pox

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

12. Securing an ET Tube
Each hospital does it differently

13. 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

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

15. Time to rock and roll!