What is the single most important and effective step in neonatal resuscitation? -
ANSWER Ventilation of the newborn's lungs
Abnormal Transition Findings - ANSWER -Irregular Breathing, absent breathing, or
rapid breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
NRP algorithm- First Step - ANSWER Antenatal Counselling
Team Debriefing
Equipment Check
After the birth of the baby, what do you ask? - ANSWER 1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do? -
ANSWER Warm
Dry
Stimulate
Position airway
Suction if needed
,Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis - ANSWER
Position airway, suction if needed
Pulse oximeter
, Oxygen if needed
Consider CPAP
Apnea or gasping? HR <100bpm= YES - ANSWER PPV
Pulse Oximeter
Consider Cardiac Monitor
HR STILL less than 100bpm= YES - ANSWER Ensure adequate ventilation
Consider ETT or laryngeal mask
Cardiac Monitor
HR <60 bpm? - ANSWER ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
HR STILL <60 bpm? - ANSWER IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
Rapid Evaluation - ANSWER Determine if the newborn can remain with the mother or
should be moved to the radiant warmer for further evaluation
REVIEW: Three questions you ask during rapid evaluation? - ANSWER 1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
Airway - ANSWER Perform the initial steps to establish an open Airway and support
spontaneous respiration
Breathing - ANSWER PPV is provided to assist Breathing for babies with apnea or
bradycardia
Circulation - ANSWER If severe bradycardia persists despite assisted ventilation,
Circulation is supported by performing chest compressions coordinated with PPV
Drug - ANSWER If severe bradycardia persists despite assisted ventilation and
coordinated chest compressions, the Drug Epinephrine is administered as coordinated
ANSWER Ventilation of the newborn's lungs
Abnormal Transition Findings - ANSWER -Irregular Breathing, absent breathing, or
rapid breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
NRP algorithm- First Step - ANSWER Antenatal Counselling
Team Debriefing
Equipment Check
After the birth of the baby, what do you ask? - ANSWER 1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do? -
ANSWER Warm
Dry
Stimulate
Position airway
Suction if needed
,Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis - ANSWER
Position airway, suction if needed
Pulse oximeter
, Oxygen if needed
Consider CPAP
Apnea or gasping? HR <100bpm= YES - ANSWER PPV
Pulse Oximeter
Consider Cardiac Monitor
HR STILL less than 100bpm= YES - ANSWER Ensure adequate ventilation
Consider ETT or laryngeal mask
Cardiac Monitor
HR <60 bpm? - ANSWER ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
HR STILL <60 bpm? - ANSWER IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
Rapid Evaluation - ANSWER Determine if the newborn can remain with the mother or
should be moved to the radiant warmer for further evaluation
REVIEW: Three questions you ask during rapid evaluation? - ANSWER 1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
Airway - ANSWER Perform the initial steps to establish an open Airway and support
spontaneous respiration
Breathing - ANSWER PPV is provided to assist Breathing for babies with apnea or
bradycardia
Circulation - ANSWER If severe bradycardia persists despite assisted ventilation,
Circulation is supported by performing chest compressions coordinated with PPV
Drug - ANSWER If severe bradycardia persists despite assisted ventilation and
coordinated chest compressions, the Drug Epinephrine is administered as coordinated
