1. Simulation: Precipitous Delivery & Neonatal Resuscitation Cindy Hsu, MD, PhD February 19 th, 2014

2. Thanks to the West Philly water, you will see one!

3. The Delivery How to catch the baby Nuchal cord issues –Wrapped around the neck –Too tight –Prolapse Delivery of the placenta Post-partum care

4. http://www.brooksidepress.org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1.htm

5. The Somersault

6. Neonatal Resuscitation

9. First, ask 3 questions:

10. What about the APGAR?

11. How do you check the pulse? What kind of air do you use? Check the HR at 30 sec

12. Check the HR at 1 min

13. Consider meds Don’t forget about hypothermia and hypoglycemia!

14. Remember the targeted O 2 sat

15. Meconium If baby is fine, perform routine care If patient is under distress, perform deep suction using an ETT and meconium aspirator

16. Intubation ETT LMA: Size 1 is suitable for infants up to 5kg Blade Size 1 for term infants Size 0 for premature infants Size 00 for extremely low birth weight infants

17. Access IO Umbilical lines IO Umbilical lines

18. Medications Epinephrine –0.1 to 0.3mL/kg of 1:10,000 (10-30 mcg/kg) –Can repeat q3-5min if HR < 60 Glucose –2mL/kg of D10W Fluid –10cc/kg NS over 5-10 minutes, can give 2 nd dose

19. Questions?

20. Helpful videos http://www.youtube.com/watch?v=h- QnKT-moeYhttp://www.youtube.com/watch?v=h- QnKT-moeY http://academiclifeinem.com/patwari- academy-videos-neonatal-resuscitation/http://academiclifeinem.com/patwari- academy-videos-neonatal-resuscitation/ http://www.brooksidepress.org/Products/O bstetric_and_Newborn_Care_II/lesson_3_ Section_1.htmhttp://www.brooksidepress.org/Products/O bstetric_and_Newborn_Care_II/lesson_3_ Section_1.htm