Resuscitation (Neonatal) - Revision history

Rossdonaldson1: Redirected page to Neonatal resuscitation

2015-05-14T18:53:28Z

Redirected page to Neonatal resuscitation

← Older revision		Revision as of 18:53, 14 May 2015
Line 1:		Line 1:
	~~== Principles of Resuscitation ==~~		#REDIRECT[[Neonatal resuscitation]]

	~~=== Thermal Regulation ===~~

	*Place newborn in neutral thermal environment even before initiate ABCs
	*Gently dry newborn with warm towel

	~~=== Airway ===~~

	*Optimize
	**Position head in sniffing position
	**Suction nose and mouth
	*Intubate
	**Indicated if pt is poorly responsive or fails BVM
	**If have time precut ET tube at 13cm mark
	**Lip placement = 6 + wt (kg)
	**After intubation suction trachea to prevent aspiration (if +meconium)

	~~{\| width="200" border="1" cellpadding="1" cellspacing="1"~~
	\|-
	~~\| Tube Size / age / wt~~
	~~\| Blade~~
	~~\| Suction Catheter~~
	\|-
	~~\| 2.5 / <28 / <1000~~
	~~\| Miller 0~~
	~~\| 5F or 6F~~
	\|-
	~~\| 3.0 / 28-34 / 1000-2000    ~~
	~~\| Miller 0~~
	~~\| 6F or 8F~~
	\|-
	~~\| 3.5 / 34-38 / 2000-3000~~
	~~\| Miller 0~~
	~~\| 8F~~
	\|-
	~~\| 3.5-4.0 />38 / >3000~~
	~~\| Miller 0-1~~
	~~\| 8F or 10F~~
	\|}


	~~===Breathing===~~

	*Apneic and/or bradycardic (<100 bpm)
	**Attempt tactile stimulation first
	**If unsuccessful perform BMV at 40-60 breaths/min
	**After intubation use:
	***Inflation pressure ~ 20

	~~===Circulation===~~
	*CPR
	**Begin if despite assisted ventilation x30s HR still <60
	**3 compressions:1 breath (total 90 compresions:30 breaths per min)
	~~====Vascular Access====~~
	*Umbilical vein is site of choice
	~~====Volume Expansion====~~
	*NS 10-20mL/kg IV over 5-10min
	*O Rh-negative blood
	~~====Medications====~~
	*Epinephrine
	**Indicated for aystole or HR < 60 despite CPR >30s
	**0.01-0.03mg/kg IVP q3-5min
	*Sodium Bicarbonate
	**Helps to counteract negative inotropy/pulm HTN caused by acidosis
	**Only give once adequate ventilation is established
	**1-2 mEq/kg of 4.2% solution (2-4 mL/kg)
	*Naloxone
	**Give if persistent resp depression AND maternal narcotics w/in 4hr
	**0.1mg/kg IV

	~~==Special Problems==~~
	~~===Cyanosis===~~
	*Must distinguish between central and peripheral
	*Consider prostaglandin E1 0.05-0.1 mcg/kg/min for cyanotic heart dz
	~~===Pneumothorax===~~
	*Tension PTX is highly related to subsequent ICH
	**Place 18-20ga catheter into 4th IC in ant axillarly line
	~~===Hypoglycemia===~~
	*<30-35 in preterm newborn
	*<35-40 in term newborn
	*Treatment
	**D10W 2mL/kg IV
	~~===Congenital Diaphragmatic Hernia===~~
	*Persistent respiratory distress w/ "seesaw" pattern
	*Treat via immediate intubation, OG tube placement
	**Use lowest peak insp presure that allows for adequate chest rise
	~~==Withholding Resuscitation==~~
	*Consider if:
	**<22wk or <400g
	**No signs of life after 10min of CPR

	~~== See Also ==~~
	[[~~Pediatric Advanced Life Support (PALS)]]~~

	~~== Source ==~~
	~~Tintinalli~~

	~~[[Category:Peds]]~~
	~~[[Category:Critical Care]]~~
	~~[[Category:EMS~~]]

Rossdonaldson1 at 18:52, 14 May 2015

2015-05-14T18:52:20Z

← Older revision		Revision as of 18:52, 14 May 2015
Line 98:		Line 98:

	[[Category:Peds]]		[[Category:Peds]]
	[[Category:~~Airway/Resus~~]]		[[Category:Critical Care]]
	[[Category:EMS]]		[[Category:EMS]]

Rossdonaldson1: /* Source */

2013-08-11T16:47:48Z

Source

← Older revision		Revision as of 16:47, 11 August 2013
Line 99:		Line 99:
	[[Category:Peds]]		[[Category:Peds]]
	[[Category:Airway/Resus]]		[[Category:Airway/Resus]]
			[[Category:EMS]]

Jswartz: /* =Vascular Access */

2011-07-08T21:05:28Z

=Vascular Access

← Older revision		Revision as of 21:05, 8 July 2011
Line 53:		Line 53:
	**Begin if despite assisted ventilation x30s HR still <60		**Begin if despite assisted ventilation x30s HR still <60
	**3 compressions:1 breath (total 90 compresions:30 breaths per min)		**3 compressions:1 breath (total 90 compresions:30 breaths per min)
	====Vascular Access===		====Vascular Access====
	*Umbilical vein is site of choice		*Umbilical vein is site of choice
	====Volume Expansion====		====Volume Expansion====

Jswartz at 21:05, 8 July 2011

2011-07-08T21:05:07Z

← Older revision		Revision as of 21:05, 8 July 2011
Line 1:		Line 1:
	== Principles of Resuscitation ==		== Principles of Resuscitation ==

	=== Thermal Regulation ===		=== Thermal Regulation ===

	*Place newborn in neutral thermal environment even before initiate ABCs		*Place newborn in neutral thermal environment even before initiate ABCs
	*Gently dry newborn with warm towel		*Gently dry newborn with warm towel

	=== Airway ===		=== Airway ===

	*Optimize		*Optimize
Line 14:		Line 14:
	**Indicated if pt is poorly responsive or fails BVM		**Indicated if pt is poorly responsive or fails BVM
	**If have time precut ET tube at 13cm mark		**If have time precut ET tube at 13cm mark
			**Lip placement = 6 + wt (kg)
	**After intubation suction trachea to prevent aspiration (if +meconium)		**After intubation suction trachea to prevent aspiration (if +meconium)

	~~<br>~~

	{\| width="200" border="1" cellpadding="1" cellspacing="1"		{\| width="200" border="1" cellpadding="1" cellspacing="1"
	\|-		\|-
	\| Tube Size		\| Tube Size / age / wt
	\| ~~Wt (gm)~~		\| Blade
	\| ~~Age (wk)~~		\| Suction Catheter
	\|-		\|-
	\| 2.5		\| 2.5 / <28 / <1000
	\| <1000		\| Miller 0
	\| ~~<28~~		\| 5F or 6F
	\|-		\|-
	\| 3.0		\| 3.0 / 28-34 / 1000-2000
	\| 1000-2000		\| Miller 0
	\| ~~28-34~~		\| 6F or 8F
	\|-		\|-
	\| 3.5		\| 3.5 / 34-38 / 2000-3000
	\| 2000-3000		\| Miller 0
	\| ~~34-38~~		\| 8F
	\|-		\|-
	\| 4.0		\| 3.5-4.0 />38 / >3000
	\| >3000		\| Miller 0-1
	\| ~~>38~~		\| 8F or 10F
	\|}		\|}

	~~<br>~~

	*Ventilate		===Breathing===
	**Apneic and/or bradycardic (<100 bpm)
	***Attempt tactile stimulation first
	***If unsuccessful perform BMV at 40-60 breaths/min
	***After intubation use:
	****Inflation pressure ~ 20

	<~~br>~~		*Apneic and/or bradycardic (<100 bpm)
			**Attempt tactile stimulation first
			**If unsuccessful perform BMV at 40-60 breaths/min
			**After intubation use:
			***Inflation pressure ~ 20

	<br>		===Circulation===
			*CPR
			**Begin if despite assisted ventilation x30s HR still <60
			**3 compressions:1 breath (total 90 compresions:30 breaths per min)
			====Vascular Access===
			*Umbilical vein is site of choice
			====Volume Expansion====
			*NS 10-20mL/kg IV over 5-10min
			*O Rh-negative blood
			====Medications====
			*Epinephrine
			**Indicated for aystole or HR < 60 despite CPR >30s
			**0.01-0.03mg/kg IVP q3-5min
			*Sodium Bicarbonate
			**Helps to counteract negative inotropy/pulm HTN caused by acidosis
			**Only give once adequate ventilation is established
			**1-2 mEq/kg of 4.2% solution (2-4 mL/kg)
			*Naloxone
			**Give if persistent resp depression AND maternal narcotics w/in 4hr
			**0.1mg/kg IV

	== ~~Work~~-Up ==		==Special Problems==
			===Cyanosis===
	== ~~DDx~~ ==		*Must distinguish between central and peripheral
			*Consider prostaglandin E1 0.05-0.1 mcg/kg/min for cyanotic heart dz
	== ~~Treatment~~ ==		===Pneumothorax===
			*Tension PTX is highly related to subsequent ICH
	== ~~See Also~~ ==		**Place 18-20ga catheter into 4th IC in ant axillarly line
			===Hypoglycemia===
			*<30-35 in preterm newborn
			*<35-40 in term newborn
			*Treatment
			**D10W 2mL/kg IV
			===Congenital Diaphragmatic Hernia===
			*Persistent respiratory distress w/ "seesaw" pattern
			*Treat via immediate intubation, OG tube placement
			**Use lowest peak insp presure that allows for adequate chest rise
			==Withholding Resuscitation==
			*Consider if:
			**<22wk or <400g
			**No signs of life after 10min of CPR

			== See Also ==
	[[Pediatric Advanced Life Support (PALS)]]		[[Pediatric Advanced Life Support (PALS)]]

	== Source ==		== Source ==

	Tintinalli		Tintinalli

	[[Category:Peds]] [[Category:Airway/Resus]]		[[Category:Peds]]
			[[Category:Airway/Resus]]

Jswartz at 20:19, 8 July 2011

2011-07-08T20:19:59Z

← Older revision		Revision as of 20:19, 8 July 2011
Line 1:		Line 1:
	==Principles of Resuscitation==		== Principles of Resuscitation ==
	===Thermal Regulation===
	*Place newborn in neutral thermal environment even before initiate ABCs		=== Thermal Regulation ===

			*Place newborn in neutral thermal environment even before initiate ABCs
	*Gently dry newborn with warm towel		*Gently dry newborn with warm towel
	===Airway===
	*Optimize		=== Airway ===
	**Position head in sniffing position
	**Suction nose and mouth		*Optimize
	*Intubate		**Position head in sniffing position
	**Indicated if pt is poorly responsive or fails BVM		**Suction nose and mouth
	**If have time precut ET tube at 13cm mark		*Intubate
			**Indicated if pt is poorly responsive or fails BVM
			**If have time precut ET tube at 13cm mark
	**After intubation suction trachea to prevent aspiration (if +meconium)		**After intubation suction trachea to prevent aspiration (if +meconium)

			<br>

			{\| width="200" border="1" cellpadding="1" cellspacing="1"
			\|-
			\| Tube Size
			\| Wt (gm)
			\| Age (wk)
			\|-
			\| 2.5
			\| <1000
			\| <28
			\|-
			\| 3.0
			\| 1000-2000
			\| 28-34
			\|-
			\| 3.5
			\| 2000-3000
			\| 34-38
			\|-
			\| 4.0
			\| >3000
			\| >38
			\|}

			<br>

			*Ventilate
	*Ventilate		**Apneic and/or bradycardic (<100 bpm)
	**Apneic and/or bradycardic (<100 bpm)		***Attempt tactile stimulation first
	***Attempt tactile stimulation first		***If unsuccessful perform BMV at 40-60 breaths/min
	***If unsuccessful perform BMV at 40-60 breaths/min		***After intubation use:
	***After intubation use:
	****Inflation pressure ~ 20		****Inflation pressure ~ 20

			<br>

			<br>


	~~==Work-Up==~~

			== Work-Up ==

	==DDx==		== DDx ==

			== Treatment ==

	==~~Treatment~~==		== See Also ==

			[[Pediatric Advanced Life Support (PALS)]]

	==~~See Also~~==		== Source ==
	~~[[Pediatric Advanced Life Support (PALS)]]~~

	~~==Source==~~		Tintinalli
	Tintinalli

	[[Category:Peds]]		[[Category:Peds]] [[Category:Airway/Resus]]
	[[Category:Airway/Resus]]

Jswartz: Created page with "==Principles of Resuscitation== ===Thermal Regulation=== Place newborn in neutral thermal environment even before initiate ABCs Gently dry newborn with warm towel ===Airway=== ..."

2011-07-08T20:17:27Z

Created page with "==Principles of Resuscitation== ===Thermal Regulation=== *Place newborn in neutral thermal environment even before initiate ABCs *Gently dry newborn with warm towel ===Airway=== ..."

New page

==Principles of Resuscitation==
===Thermal Regulation===
*Place newborn in neutral thermal environment even before initiate ABCs
*Gently dry newborn with warm towel
===Airway===
*Optimize
**Position head in sniffing position
**Suction nose and mouth
*Intubate
**Indicated if pt is poorly responsive or fails BVM
**If have time precut ET tube at 13cm mark
**After intubation suction trachea to prevent aspiration (if +meconium)

*Ventilate
**Apneic and/or bradycardic (<100 bpm)
***Attempt tactile stimulation first
***If unsuccessful perform BMV at 40-60 breaths/min
***After intubation use:
****Inflation pressure ~ 20

==Work-Up==

==DDx==

==Treatment==

==See Also==
[[Pediatric Advanced Life Support (PALS)]]

==Source==
Tintinalli

[[Category:Peds]]
[[Category:Airway/Resus]]