Neonatal Resuscitation

-BLS-

RC 290
Equipment Needed
Overhead radiant warmer
Bulb syringe
BVM with heated &
humidified O2
De Lee suction device
Size 5 Fr suction catheters
and wall suction
Laryngoscope with proper
sized blades
Proper sized ET tubes
Crash cart/Drug box
Normal Delivery Procedures
Place under warmer and
towel dry
Use bulb syringe to clear
mouth, than nose
Tactile stimulation if not
breathing yet
Auscultate heart and lungs &
assess color
Prophylactic silver nitrate or
erythromycin drops in eyes
Vitamin K injection
Examine umbilical cord
Free flow O2 as needed
 Free Flow O2

Hold O2 connecting tubing ½ inch from infants face.

Run flow at 5 LPM
 Resuscitation

Maternal causes: Fetal Causes

– Drugs – Cord compression
– Cardiopulmonary – Prematurity
problems – Congenital anomalies
– Infection – Multiple pregnancy
– Dystocia – Meconium aspiration
– Utero-Placental problems – Hypothermia
– shock
NRP Resuscitation Algorithm
Meconium Baby
Airway is aggressively
cleared prior to drying if
infant is meconium stained
AND baby is NOT vigorous!
– Use ET tube as a suction
device
May need PD & P after heart
rate, respirations, and color
stabilize
If baby is meconium stained
but vigorous, proceed with
normal resuscitation
Bagging a Neonate
BVM Devices
 BVM Devices

Flow-dependent anesthesia bag

Bagging Technique

Place infant in “sniffing”

position by placing a
small towel under the
shoulders
Do not hyperextend
neck!
Bagging technique (cont.)

Apply correctly sized

mask over infants mouth
and nose with apex of
mask over bridge of nose
Run either type of bag at 5-8
LPM to get 100% FIO2
– If self-inflating bag, use
reservoir also
Watch for slight rise of chest
(Vt ~ 20-30 ml)
Rate is 40-60
Pressure
– First breath may require 30-40
cmH2O
– Then, with normal lungs, 15-20
cmH2O
– Poor lung compliance may
require sustained 20-40
cmH2O
 If BVM ventilation lasts over 2
minutes…

Than an orogastric tube has to be

inserted
 Neonatal PD & P

Meconium babies and/or Maintain airway

C section babies throughout using one
hand on head
No more than 20
degrees of Suction PRN
Trendelenberg or ICP will Besides suction, need
increase BVM and O2
Monitor heart rate,
Percuss anterior and respirations and color
lateral surfaces 1-2 throughout
minutes
Neonatal PD & P Percussors
 Neonatal Chest Compressions

Asystole or bradycardia less than 60 that is not increasing with

airway and ventilation
Use thumbs on lower half of sternum (one finger’s width below
nipple line)
Compress ½ to ¾ of an inch, 120 times per minute
Compression ventilation ratio is 3:1 (pause to give breath)
The End Result