NRP 9th edition | UPDATED Questions with 100% Verified Answers
Question:
4 pre-birth questions
Answer:
(1) Gestational age? (2) Amniotic fluid clear? (3) Additional
risk factors? (4) Umbilical cord management plan?
Question:
How many people in a team?
Answer:
·Every birth should have at least one NRP qualified person who
only focuses on the baby.
·At least two NRP people should go for the baby if risks are
present.
·A full team (minimum 4 people) needs to be immediately
available for resuscitation. Need to be able to do
compressions, intubate, emergency vascular access, and med
admin.
Question:
How many people if meconium is the only risk?
Answer:
Two NRP people, and someone who can intubate needs to be
immediately available
Question:
Delivery equipment essentials?
Answer:
WARM: Preheated radiant warmer, blankets/towels, hat,
plastic wrap and thermal mattress (for under 32wk). CLEAR
AIRWAY: bulb syringe, 10-12Fr deep suction hooked up,
tracheal aspirator, LISTEN: stethoscope. VENTILATE: Flow
,meter set 10L/min, t piece or bag, term and preterm face
masks, OG tube and 20ml syringe, and LMA with 5ml
syringe for mask inflation. OXYGENATE: O2 blender, pulse
ox with sensor and cover, target o2 sat table, equipment to
give blowby. INTUBATE: laryngoscope size 0 and 1 straight
blades (size 00 is optional). ET tubes sizes 2-3.5. Stylet. CO2
detector. Measuring tape or et tube insertion depth table. Tape
or tube securing device. Scissors. MEDICATE: EPI
(0.1mg/mL aka 1mg/10mL), normal saline flushes or a full IV
bag's worth, equipment to place UVC and give meds, and
table of precalculated emergency med dosages for babies
0.5-4kg
Question:
9TH EDITION VENTILATION SETTINGS
Answer:
FiO2: <32wk = 30-100% 32-34wk =21-30% 35+wk=21%
Gas flow = 10LPM Rate = 30-60 PIP: 25cmH2O with a range
of 25-30 for 32+wk GA and 20-25 for <32wk PEEP 5cmH2O
Question:
Benefits of delayed cord clamping... TERM baby
Answer:
May improve hematologic measurements Uncertain but may
improve neurodevelopmental outcomes. However... increased
chance of needing phototherapy
Question:
Benefits of delayed cord clamping... PRETERM baby
Answer:
Decreased chance of needing BP meds after birth, decreased
chance or # of blood transfusions needed during hospital stay,
and possibly improved survival.
, Question:
Per NRP, umbilical cord clamp delay should be how long?
What are current thoughts on umbilical cord milking?
Answer:
Current evidence suggests that clamping should be deferred
for at least 60 seconds. 35+ week infants who are still
non-vigorous despite stimulation may benefit from milking
the intact umbilical cord instead of early cord clamping. They
stroke the cord upward over 2-3 seconds, let the cord refill
with blood, and that is done 4 times before clamping and
cutting. HOWEVER... for non-vigorous preterm infants, 34
weeks-28wk, there's not enough evidence to recommend
routinely milking the intact umbilical cord, and we should not
do it at all for infants under 28 weeks due to the risk of severe
IVH.
Question:
What is one of the key goals during deferred cord clamping
Answer:
The goal is to allow the baby to spontaneously take a breath
while the cord is still intact
Question:
Why do we delay cord clamping
Answer:
At the time of birth, a large volume of fetal blood remain
remains in the placenta. If maternal blood flow is still flowing
to the placenta, and the umbilical cord has not been clamped,
placental gas exchange will continue and additional
oxygenated blood will be returned to the baby.
Question:
What does peep help achieve?
Question:
4 pre-birth questions
Answer:
(1) Gestational age? (2) Amniotic fluid clear? (3) Additional
risk factors? (4) Umbilical cord management plan?
Question:
How many people in a team?
Answer:
·Every birth should have at least one NRP qualified person who
only focuses on the baby.
·At least two NRP people should go for the baby if risks are
present.
·A full team (minimum 4 people) needs to be immediately
available for resuscitation. Need to be able to do
compressions, intubate, emergency vascular access, and med
admin.
Question:
How many people if meconium is the only risk?
Answer:
Two NRP people, and someone who can intubate needs to be
immediately available
Question:
Delivery equipment essentials?
Answer:
WARM: Preheated radiant warmer, blankets/towels, hat,
plastic wrap and thermal mattress (for under 32wk). CLEAR
AIRWAY: bulb syringe, 10-12Fr deep suction hooked up,
tracheal aspirator, LISTEN: stethoscope. VENTILATE: Flow
,meter set 10L/min, t piece or bag, term and preterm face
masks, OG tube and 20ml syringe, and LMA with 5ml
syringe for mask inflation. OXYGENATE: O2 blender, pulse
ox with sensor and cover, target o2 sat table, equipment to
give blowby. INTUBATE: laryngoscope size 0 and 1 straight
blades (size 00 is optional). ET tubes sizes 2-3.5. Stylet. CO2
detector. Measuring tape or et tube insertion depth table. Tape
or tube securing device. Scissors. MEDICATE: EPI
(0.1mg/mL aka 1mg/10mL), normal saline flushes or a full IV
bag's worth, equipment to place UVC and give meds, and
table of precalculated emergency med dosages for babies
0.5-4kg
Question:
9TH EDITION VENTILATION SETTINGS
Answer:
FiO2: <32wk = 30-100% 32-34wk =21-30% 35+wk=21%
Gas flow = 10LPM Rate = 30-60 PIP: 25cmH2O with a range
of 25-30 for 32+wk GA and 20-25 for <32wk PEEP 5cmH2O
Question:
Benefits of delayed cord clamping... TERM baby
Answer:
May improve hematologic measurements Uncertain but may
improve neurodevelopmental outcomes. However... increased
chance of needing phototherapy
Question:
Benefits of delayed cord clamping... PRETERM baby
Answer:
Decreased chance of needing BP meds after birth, decreased
chance or # of blood transfusions needed during hospital stay,
and possibly improved survival.
, Question:
Per NRP, umbilical cord clamp delay should be how long?
What are current thoughts on umbilical cord milking?
Answer:
Current evidence suggests that clamping should be deferred
for at least 60 seconds. 35+ week infants who are still
non-vigorous despite stimulation may benefit from milking
the intact umbilical cord instead of early cord clamping. They
stroke the cord upward over 2-3 seconds, let the cord refill
with blood, and that is done 4 times before clamping and
cutting. HOWEVER... for non-vigorous preterm infants, 34
weeks-28wk, there's not enough evidence to recommend
routinely milking the intact umbilical cord, and we should not
do it at all for infants under 28 weeks due to the risk of severe
IVH.
Question:
What is one of the key goals during deferred cord clamping
Answer:
The goal is to allow the baby to spontaneously take a breath
while the cord is still intact
Question:
Why do we delay cord clamping
Answer:
At the time of birth, a large volume of fetal blood remain
remains in the placenta. If maternal blood flow is still flowing
to the placenta, and the umbilical cord has not been clamped,
placental gas exchange will continue and additional
oxygenated blood will be returned to the baby.
Question:
What does peep help achieve?
