Neonatal Resuscitation (Newborn Resuscitation) : Algorithm, Steps, Procedure, & Guidelines (NRP Guidelines)
Resuscitation Algorithm
|
↓Any no
|
↓
OR
|
↓Yes
|
↓
Heart rate < 100/min? |
↓Yes
Ventilation Corrective Steps* |
↓
Heart rate < 60/min? |
↓Yes
|
↓
Heart rate < 60/min? |
↓Yes
Drugs |
Stimulation
- Rubbing the back, or
- Flicking the sole.
Positive Pressure Ventilation (PPV) :
- Given by Bag & Mask Ventilation (BMV)
- Bag used in resuscitation: AMBU Bag
- Capacity of AMBU Bag: 240-750 ml
Contraindications for BMV are
- Absolute C/I: Congenital diaphragmatic hernia
- Relative C/I: Tracheoesophageal fistula, Meconium aspiration syndrome (MAS)
Ventilation Corrective Steps
MRSOPA
- M : Mask to be reapplied
- R : Reposition head
- S : Secretion suctioned (Mouth is suctioned first followed by nose) : Trachea is not suctioned.
- O : Open mouth
- P : Pressure during PPV to be increased
- A : Alternate airway to be considered (due to suspected blockage)
Chest Compression
- Two thumb or Two hand technique (BEST)
- Two finger or Single hand technique
Coordination
Chest compression : Ventilation :: 3 : 1
e.g. 1 min → 90 compression & 30 ventilation ⇒ Total events 120
Endotracheal intubation
Appropriate endotracheal tube size is
Inner diameter of tube (mm) | Weight (g) | Gestational age (weeks) |
2.5 | <1000 | <28 |
3.0 | 1000-2000 | 28-34 |
3.5 | 2000-3000 | 34-38 |
4.0 | >3000 | >38 |
Resuscitation in Meconium-Stained Liquor (MSL) Babies
See whether baby is vigorous or not.
|
↓Any NO
|
↓
Needs Resuscitation
Only intubation, short PPV & chest compression |
↓
|
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