1. BY DR SHANZA
AUROOJ

2. WHAT IS NEONATAL RESUSCITATION?
 Neonatal Resuscitation is
intervention after a baby is born
to help it breathe and to help its
heart beat.

3. Before a baby is born,
the placenta provides
oxygen and nutrition
to the blood and
removes carbon
dioxide.
After a baby is born,
the lungs provide
oxygen to the blood
and remove carbon
dioxide

4. The transition from using the
placenta to using the lungs for
gas exchange begins when
the umbilical cord is clamped
or tied off, and the baby has its
first breath.
Many babies go through this
transition without needing
intervention.
Some babies need help with
establishing their air flow,
breathing, or circulation

6. PREPARATION FOR
RESUSCITATION
ANTICIPATION
ADEQUATE
EQUIPMENT
ADEQUATE
PERSONNEL

7. EQUIPMENT REQUIRED
 RESUSCITATION TABLE
 STERILE LINEN
 SUCTION APPARATUS
 LARYNGOSCOPE
 AMBU BAG & FACE MASKS
 ORAL AIRWAYS
 OXYGEN WITH FLOW METER & TUBING
 ENDOTRACHEAL TUBES
 SCISSORS GLOVES

8. MEDICATIONS
 Epinephrine
 Naloxone hydrochloride
 Volume expanders
 Normal saline
 Albumin 5%
 Ringer lactate
 Sodium bicarbonate4.2%
 Dextrose water 10%
 Sterile water

9. MISCELLENOUS
 Radiant warmer
 Stethoscope
 Adhesive tape
 Syringes
 Butterfly needles
 Umbilical artery catheterization tray
 Umbilical catheter 3 & 5 fr
 Feeding tube
 Spirit sponges

13. Clear of meconium
Breathing or crying?
Good muscle tone?
Color pink?
Term gestation?
Provide warmth
Position (clear airway)
Dry,stimulate,reposition
Give Oxygen
Evaluate respiration,heart
rate & colour
Routine care:
•Provide warmth
•Clear airway
•dry
Provide positive
pressure ventilation
Provide positive pressure ventilation
Administer chest compression
Administer adrenaline
Supportive care
Ongoing care
YES
NO
Breathing HR>100 &
PINK
APNEA Or HR<100
VENTILATING
HR>100 &
PINK
HR<60 HR>60
HR<60 HR>60

14. HOW TO PREVENT HEAT LOSS?
 Place the infant under
radiant heat source
 Dry off the amniotic fluid

15. What is the correct position?
How to clear airway?
 Place the newborn in
a supine position with
neck semi
extended,use a
shoulder role to keep
neck extended
 Suction the infant’s
mouth and nose

16. INITIATE BREATHING
 Use tactile stimulation
 Employ positive pressure
ventilation when necessary
using
 Bag & mask
 Bag & endotracheal tube
 Ventilation rate=40/min
 Ventilation pressure=15-20cm
of water
 Continue ventilation for 15-30
minutes

17. WHAT ARE THE WAYS TO MAINTAIN
CIRCULATION?
 Chest compression=when
HR<60/min
 Sternum should be compressed ½
inch with PPV at the ratio of 3: 1
 Encircle the chest with overlapping
thumbs or
 Place middle & index finger of one
hand right angle to the chest wall over
sternum
 Continue for 30 seconds,if HR>60 &
increasing stop compressions

18. When to use medication?
 When HR is not increasing despite adequate ventilation with 100%
oxygen & chest compression then use drugs to stimulate heart
 ADRENALINE(1:10,000): 0.1-0.3 ml/kg IV, repeated every 3-5 min
 Volume expanders(N/S,R/L,5% albumin): 10 ml/kg IV 5-10/min
 Sodium bicarbonate:prolonged cardiac arrest 1-2 meq/kg IV
 Naloxone hydrchloride: 0.1 mg/k IV,maternal narcotics administration
within 4 hours
 Dopamine: continued shock,dose=5-20 mg/kg/min,continous