Simulation: Precipitous Delivery & Neonatal Resuscitation

Cindy Hsu, MD, PhD

February 19th, 2014

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

The Delivery

• How to catch the baby

• Nuchal cord issues– Wrapped around the neck– Too tight– Prolapse

• Delivery of the placenta

• Post-partum care

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

The Somersault

Neonatal

Resuscitation

First, ask 3 questions:

What about the APGAR?

How do you check the pulse?What kind of air do you use?

Check the HR at 30 sec

Check the HR at 1 min

Consider meds

Don’t forget about hypothermia and hypoglycemia!

Remember the targeted O2sat

Meconium

• If baby is fine, perform routine care

• If patient is under distress, perform deep suction using an ETT and meconium aspirator

IntubationETT

LMA: Size 1 is suitable for infants up to 5kg

BladeSize 1 for term infantsSize 0 for premature infantsSize 00 for extremely low birth weight infants

Access

• IO

• Umbilical lines

• IO

• Umbilical lines

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 2nd

dose

Questions?

Helpful videos

• http://www.youtube.com/watch?v=h-QnKT-moeY

• http://academiclifeinem.com/patwari-academy-videos-neonatal-resuscitation/

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