Q&A
A baby is born at term with a bilateral cleft lip and palate and a very small
mandible. She requires positive-pressure ventilation because she is not breathing.
You are unable to achieve a seal with bag and mask. Which intervention is
indicated?
- Insert a laryngeal mask
You are at the resuscitation of a newborn who is gasping and has a heart rate of 60
beats per minute. What is the most important action you can take?
- Provide positive-pressure ventilation
What size (internal diameter) endotracheal tube should be used to intubate a
newborn with an estimated gestational age of 26 weeks (estimated birth weight of
800 g)?
- 2.5 mm
Your team attends an emergency cesarean delivery of a term baby because of
chorioamnionitis, meconium-stained amniotic fluid, and fetal heart rate
decelerations. At delivery, the newborn is term as expected, with very poor tone
and he is not breathing (apneic). You quickly perform initial steps, but the newborn
is still not breathing. What is the most appropriate next step of resuscitation?
- Start positive-pressure ventilation and check heart rate response after 15 seconds
During the resuscitation of a newborn, you auscultate the apical pulse and count 10
beats over a 6 second period. What heart rate do you report to your team?
- 100 beats per minute
You are part of a team preparing for the birth of a baby who has meconium-stained
fluid and a category III fetal heart rate tracing. A person skilled in endotracheal
intubation should be
- Present at the birth.
, You are at a delivery of a baby born through meconium-stained amniotic fluid, and
the baby is not vigorous. What steps should be taken immediately after birth?
- The baby should be brought to the radiant warmer for initial steps of newborn
care.
What is the most effective maneuver to establish spontaneous breathing in a baby
that is apneic after initial steps?
- Administration of positive-pressure ventilation that inflates the lungs
A newborn of 34 weeks' gestation is not breathing (apneic) at birth, does not
respond to initial steps and requires positive-pressure ventilation. What
concentration of oxygen should be used as you begin positive-pressure ventilation?
- 21 - 30% oxygen
You have started positive-pressure ventilation for a newborn because her heart rate
is low (bradycardia). What is the most important indicator of successful positive-
pressure ventilation?
- A rising heart rate
A baby requires positive-pressure ventilation because she is not breathing (apneic),
but she soon establishes spontaneous respirations and a heart rate over 100 beats
per minute. Her oxygen saturation is lower than the target level when in room air,
so you provide free-flow oxygen. Which of the following devices cannot reliably
deliver free-flow oxygen?
- Mask of self-inflating bag
Which statement best describes normal transitional physiology at the time of birth?
- Babies may take as long as 10 minutes after birth to increase their oxygen
saturation to greater than 90%.
A baby is born at 34 weeks' gestation. After the initial steps of resuscitation, the
baby is not breathing (apneic). What are the next steps?
- Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right
hand or wrist, evaluate heart rate.