Neonatal Resuscitation – Demonstration

one of the most important things for
neonatal resuscitation is that you prepare where you can. You need to be
familiar with what equipment you have in your practice area that will enable you
to give support during resuscitation of the neonate. You need a minimum of two towels to dry and wrap the baby with. You need a stethoscope because that is best practice for checking baby’s heart rate and you need to be able to give some
ventilation support either with a bag valve mask or you get familiar with your
resusitaire that is in your area. It’s very important to make sure that you’ve got
appropriately sized masks. So in order to it appropriately assess the baby, the baby
is brought to your prepared area. It’s very important to dry the baby
thoroughly and then remove the wet towel from the baby and then the baby wrapped in the dry. Your assessment should always include colour – colour of the baby, tone –
whether the baby has any tone, breathing – is the baby trying to breathe or is it
crying, and heart rate. Best practice is that you measure the baby’s heart rate
using a stethoscope. This is an adult one but a neonatal one would always be
useful as well. When you check the baby’s heart rate you must always tap it out. This indicates to other professionals that
are with you the condition of the baby.
So just to recap. Colour, tone, breathing and heart rate. Do I need to call for
help at this point. so A for airway. If the baby is not
breathing or is gasping, then we need to open up the baby’s airway. With a baby
it’s a very subtle maneuver. The head needs to be placed into the neutral
position. This means that the baby’s face is parallel to the surface the baby
is lying on. Sometimes you have to get down to have a look to check the baby’s head is indeed in neutral If this makes no difference then we need
to give the baby five inflation breaths. In order to give the baby inflation
breaths we need to find an appropriately sized mask. The mask should be a perfect size that fits in the baby’s cleft of the chin and is rolled over the baby’s
nose and mouth and fits as tightly as possible. It shouldn’t go into the baby’s
eye socket area. Once you’ve sized the mask up you then
attach it to the device you’re going to use and in this instance we’re going to
use a bag valve mask, then we’re going to roll that back over, over to the baby’s
nose and mouth using a C and E position applaud in the mask in place to prevent
any air escaping and we’re going to give five long sustained inflation breaths.
These breathes should last two to three seconds each. When you’re giving these
inflation breaths you should watch the chest to see if the chest is rising, thus
initiating that you know you’ve got your inflation breaths working. 1 2 3
off, 2 2 3 off 3 2 3 off 4 2 3 off 5 2 3 off. If you don’t manage to see any chest
movement during that time you need to reassess the airway. The head may need to be put in a different position. so once you have given your five
inflation threats and you think that they have been successful because you
have seen the chest rise and fall, baby should be reassessed again. Colour, tone
breathing and heart rate and once again the heart rate is checked with the
stethoscope, tapping out the rate so the professionals around you know the
condition of baby. If you’ve successfully achieved airway
and breathing and that you’ve opened up the Airways successfully enough to make the chest rise and fall when you’ve given your inflation breaths you then are
able to give a further 30 seconds of ventilation support if the heart rate is
still slow. These ventilation breaths are much shorter and last just one to two
seconds each. 1 second on 1 second off. 1 second
on 1 second off. That’s done for a further 30 seconds before you reassess
the baby again. Colour, tone breathing and heart rate –
once again listening to the baby’s heart rate and tapping it out. If the heart rate
still remains slow at this point. Then you go on to give cardiac compressions.
Cardiac compressions can be done in two different ways. Best practice is the
encircling technique where the person who is supporting you encircles the baby’s
chest and places their thumbs on top of each other on the inter-nipple line, which
is just a little bit lower than the nipples on the sternum centrally. The
baby’s chest is then depressed by a third and released again and this happens
3 times to every 1 ventilation breath. So just to recap, the ratio at
this point is 1 ventilation breath to 3 chest compressions. That is
done for a further 30 seconds and then the baby is reassessed again. Colour, tone
breathing, heart rate. If you’re unable to give the encircling technique because ithe
baby is quite large or your hands are too small, although there are other
people around the baby giving other aspects of care then the two-finger
approach can be used. In the two-finger approach, the two fingers are placed
directly on the baby’s sternum on the inter-nipple line and the chest is
compressed by a third. The action must be a downward action.
It mustn’t be pushed over to one side. The fingers must be upright. 3
compressions are given in the same way

12 Replies to “Neonatal Resuscitation – Demonstration”

  1. We don't cover the baby… cuz it obscures our view of respiratory rate and cyanosis…plus we put the baby under radiant warmer… so no need of covering the baby

  2. Have you heard of the Resus-A-Cradle? It holds the baby in the proper position for resuscitation to make it easy and safe.

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