Ncm102 Newborn Cpr

8/7/2019 Ncm102 Newborn Cpr

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NEWBORN

RESUSCITATION

(NEWBORN CPR)BSN 12C

MADELINE N. GERZON, RN, MM

Clinical Instructor

Davao Doctors College


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Objectives

By the end of this session, students will be able

to:

1. Define Newborn CPR

2. Determine conditions of mother that warrant

newborn CPR immediately after delivery

3. Distinguish newborn that requires CPR(resuscitation) through careful assessment

4. Identify equipment to perform newborn CPR

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Objectives

By the end of this session, students will be

able to:

5. Familiarize the skills in newborn CPR

(resuscitation)

6. Discuss relevant nursing responsibilities

during newborn CPR

7. Perform return-demonstration of newborn

CPR.

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INTRODUCTION


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Newborns & Neonates

High-Risk Newborn Patients

APGAR Scoring

Newborn Resuscitation

Special Situations

Topics


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Neonate

An infant from the time of birth to

one month of age

Newborn

A baby in the first few hours of its life,

also known as newly born infant

Introduction

Source: World Health Organization, 2010)


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Introduction

Neonate: 0-28

days

Newly born:Immediately at

birth when fetus is

physiologicallyconverting to

newborn life

Source: the Pediatric Emergency Medicine Resource


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Term newborn


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HIGH RISK NEWBORN


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CONDITIONS THAT WARRANT CPR?


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Urgent Maternal History

Is the baby more than four weeks early?

If the water has broken, was the fluidbrownish or greenish in color?

Multiple births expected?

Narcotic drugs recently?


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Brief Resuscitation-Oriented History


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HIGH RISK-NEWBORN


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Epidemiology

Approx. 6% of field deliveries requirelife support.

The incidence of complicationsincreases as the birth weightdecreases.

Approx. 80% of newborns weighing1500 g (3 pounds, 5 ounces) at birthrequire resuscitation.


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Pathophysiology

Dramatic changes occur within the

newborn to prepare it for extrauterine

life.

Fluid in the fetal lungs will be forced out

of the lungs during delivery by

compression of the chest and by entry

of air into the lungs.


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Factors that stimulate the babys

first breath

Mild acidosis

Initiation of stretch reflexes in the lungs

Hypoxia

Hypothermia


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Hemodynamic changes

in the newborn at birth


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Normal heart rate 150180 per minute.

Slowing to 130140 thereafter.

A pulse less than 100 indicates distress.

Normal respiratory rate 4060 per minute.

Evaluate skin color as well.

Use the APGAR score.

Assessment


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APGAR Scale


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What should you expect?


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Birth Asphyxia


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Birth Asphyxia - the failure

to initiate and sustain

breathing at birth


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Management ofBirth

Asphyxia

1)Basic Resuscitation

2)Advanced

Resuscitation


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Nursing Responsibilities!!!!!


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TWO SCENARIOS

Baby-out

Baby about to be delivered


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Preparation for Delivery

Assume that the infant will be depressed

Locate all necessary equipment in

advance


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Check that all needed equipment and instruments

for delivery care, essential maternal and newborn

care, newborn resuscitation, and adult

resuscitation are:

Available

In good working order

Clean/sterile

Ready and accessible

Equipment and supplies

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Equipment and supplies

Radiant heater

Dry and sterile towels

Blankets

Clock


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Equipment for Newborn

Resuscitation

Manual resuscitator (infant)

Masks (2 sizes, term and premature)

Suction equipment

ET tubes (sizes 2.5, 3.0, 3.5)

Laryngoscope and blades (sizes 0, 1)


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Manual resuscitators


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Masks


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Suction device


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ET Tube


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Laryngoscope and blades


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What else is there to prepare?


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Ensure that all surfaces the baby come in

contact with are clean (with some being

covered by sterile linen), warm, and dry

Check that the necessary items for infection

prevention are available: water, soap, injection

safety box, bucket with a decontamination

solution, etc.

Delivery room


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Make sure that the room is warm (around 25-

28 rC/ 77.0-82.4 rF) and free from drafts from

open windows and doors, with fans and air

conditioning being adjusted as needed

If the temperature of the room is less than

optimal, turn the heater on, if one is available,

at the place where special care of the baby will

be carried out

Delivery room temperature andlighting

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Where a heater is available, place the

baby linen under/near it for warming

before delivery

Make sure the room is well-lit

Delivery room temperature andlighting

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Make sure the table/surface where newbornresuscitation and special care will be provided:

Is clean, warm, dry, and without air drafts

With clean mattress that can be

decontaminated or washed between babies

and covered with sterile cloth

Newborn baby corner

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Make sure the table/surface where newbornresuscitation and special care will be provided:

Is well-lit

Has a heat source where possible

Has all of the necessary equipment, supplies,and medications for essential newborn care

and newborn resuscitation

Newborn baby corner

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Ncm102 Newborn Cpr