NEONATE VS NEWBORN
NEONATE: WITHIN FIRST MONTH AFTER BIRTH
NEWBORN: WITHIN FIRST FEW HOURS AFTER BIRTH
MORTALITY INCREASES AS
BIRTH WEIGHT AND GESTATIONAL AGE DECREASE
THREE MAJOR BLOOD FLOW DEVIATIONS OR SHUNTS
DUCTUS VENOSUS
FORAMEN OVALE
DUCTUS ARTERIOSUS
THESE CLOSE OFF AT BIRTH
DUCTUS VENOSUS**
BYPASSES LIVER
FORAMEN OVALE**
CONNECTION BETWEEN ATRIUMS
DUCTUS ARTERIOSUS**
CONNECTION BETWEEN PULMONARY ARTERY AND AORTA
FIRST BREATH IS TRIGGERED BY
MILD HYPOXIA AND HYPERCAPNIA
PULMONARY VASCULAR RESISTANCE DROPS AS THE LUNGS FILL WITH AIR
MORE BLOOD FLOWS TO THE LUNGS
DELAY IN DECREASE OF PULMONARY PRESSURE LEADS TO:
DELAYED TRANSITION
HYPOXIA
BRAIN INJURY
DEATH
NEWBORNS ARE AT RISK FOR?
HYPOTHERMIA
-PLACE ON PREWARMED TOWELS OR RADIANT WARMER
-DRY THE HEAD AND BODY THOROUGHLY
, -REMOVE WET TOWELS AND COVER WITH A DRY TOWEL
-COVER THE HEAD WITH A CAP
ALL BABIES ARE ?
CYANOTIC RIGHT AFTER BIRTH
IF THE NEWBORN REMAINS VIGOROUS AND BEGINS TO TURN PINK IN THE FIRST 5 MINUTES
MAINTAIN ONGOING OBSERVATION
CONTINUE THERMOREGULATION WITH DIRECT SKIN-TO-SKIN CONTACT WITH THE MOTHER
IF THE NEWBORN'S PULSE RATE IS APNEIC OR LESS THAN 100 BPM
BEGIN PPV
BEGIN CHEST COMPRESSIONS IF THE NEWBORN'S PULSE RATE IS LESS THAN
60 BPM
IF VENTILATION AND CHEST COMPRESSION DO NOT IMPROVE THE BRADYCARDIA
ADMINISTER EPINEPHRINE, PREFERABLY VIA IV LINE
CAUSES OF DELAYED TRANSITION IN NEWBORNS
HYPOXIA
MECONIUM OR BLOOD ASPIRATION
ACIDOSIS
HYPOTHERMIA
PNEUMONIA
HYPOTENSION
SEPSIS
BIRTH ASPHYXIA
PULMONARY HYPOPLASIA (UNDERDEVELOPMENT OF THE LUNGS)
RESPIRATORY DISTRESS SYNDROME
AFTER ENSURING AIRWAY PATENCY, DRY AND STIMULATE NEWBORN
POSITION INFANT ON BACK ON SIDE WITH NECK IN SNIFFING POSITION
STIMULATE BY DRYING NEWBORN AND FLICKING SOLES OF FEET
CONSIDER SUCTIONING IF PPV IS NEEDED OR AIRWAY APPEARS OBSTRUCTED
FREE-FLOW (BLOW-BY) OXYGEN
IF CYANOTIC OR PALE, PROVIDE O2
IF PPV IS NOT INDICATED, OXYGEN CAN INITIALLY BE DELIVERED THROUGH
-O2 MASK