Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword (1)
- Foreword (2)
- Preface
- Acknowledgments
- Section 1 Organization of neonatal transport
- Section 2 Basics in cardiopulmonary resuscitation of newborn infants
- Basic equipment setup for initial neonatal care and resuscitation
- Drugs for neonatal emergencies
- Postnatal cardiopulmonary adaptation
- ABC Techniques and Procedures
- Sunctioning
- Stimulation, oxygen supplementation, bag-and-mask ventilation (M-PPV), pharyngeal/bi-nasal CPAP, and pharyngeal positive pressure ventilation
- Endotracheal intubation and gastric tube placement
- Laryngeal mask airway (LMA)
- Chest compressions
- Peripheral venous access
- Umbilical vein/artery catheterization (UVC, UAC)
- Central venous access (internal jugular vein)
- Intraosseous access
- Cord clamping
- Management of high-risk infants in the delivery room
- Monitoring in the delivery room and during neonatal transport
- Hygiene in the delivery room and during neonatal transport (infection control)
- When to call a pediatrician to the delivery room
- Checklist for the postnatal treatment of newborn infants
- Assigning individual duties in the delivery room
- Clinical assessment of the newborn infant
- Cardiopulmonary resuscitation of newborn infants at birth
- Volume therapy and sodium bicarbonate supplementation in preterm and term newborn infants
- Absolute and relative indications for neonatal transport and NICU admission
- Communication with mother and father
- Coordinating neonatal transport and patient sign-out to the NICU team
- Documentation and feedback after neonatal emergency transport
- Ethics in neonatal intensive care
- Perinatal images of preterm and term infants
- Mechanical ventilation of the neonate
- Questions for review (basics)
- References (Section 2)
- Section 3 Classic and rare scenarios in the neonatal period
- Section 4 Transport
- Section 5 Appendix
- Index
- Plate section
Management of high-risk infants in the delivery room
from Section 2 - Basics in cardiopulmonary resuscitation of newborn infants
Published online by Cambridge University Press: 05 March 2012
- Frontmatter
- Contents
- List of contributors
- Foreword (1)
- Foreword (2)
- Preface
- Acknowledgments
- Section 1 Organization of neonatal transport
- Section 2 Basics in cardiopulmonary resuscitation of newborn infants
- Basic equipment setup for initial neonatal care and resuscitation
- Drugs for neonatal emergencies
- Postnatal cardiopulmonary adaptation
- ABC Techniques and Procedures
- Sunctioning
- Stimulation, oxygen supplementation, bag-and-mask ventilation (M-PPV), pharyngeal/bi-nasal CPAP, and pharyngeal positive pressure ventilation
- Endotracheal intubation and gastric tube placement
- Laryngeal mask airway (LMA)
- Chest compressions
- Peripheral venous access
- Umbilical vein/artery catheterization (UVC, UAC)
- Central venous access (internal jugular vein)
- Intraosseous access
- Cord clamping
- Management of high-risk infants in the delivery room
- Monitoring in the delivery room and during neonatal transport
- Hygiene in the delivery room and during neonatal transport (infection control)
- When to call a pediatrician to the delivery room
- Checklist for the postnatal treatment of newborn infants
- Assigning individual duties in the delivery room
- Clinical assessment of the newborn infant
- Cardiopulmonary resuscitation of newborn infants at birth
- Volume therapy and sodium bicarbonate supplementation in preterm and term newborn infants
- Absolute and relative indications for neonatal transport and NICU admission
- Communication with mother and father
- Coordinating neonatal transport and patient sign-out to the NICU team
- Documentation and feedback after neonatal emergency transport
- Ethics in neonatal intensive care
- Perinatal images of preterm and term infants
- Mechanical ventilation of the neonate
- Questions for review (basics)
- References (Section 2)
- Section 3 Classic and rare scenarios in the neonatal period
- Section 4 Transport
- Section 5 Appendix
- Index
- Plate section
Summary
Diagnostics in the delivery room
The pulse oximetry transducer (for SaO2 and HR monitoring) is secured with elastic tape by the second or third assistant, preferably on the neonate's right hand, after suctioning and drying (i.e., within first minute of life). Pulse oximetry is used for monitoring during neonatal resuscitation and transport (see pp. 131–2). SpO2 and blood pressure values obtained from the right arm and leg may provide information on right-to-left (ductal) shunting and outflow tract obstructions (e.g., coarctation of the aorta, interrupted aortic arch); the latter are rarely immediately evident in the delivery room since a large patent ductus arteriosus is common and may “bridge” outflow tract obstruction in these lesions. Capillary or venous blood gas analysis and blood glucose sticks (quick test with test strips) should be performed for all initially depressed neonates with metabolic acidosis (umbilical arterial pH <7.15), for preterm infants and for growth-restricted term infants. An arterial blood gas analysis is the gold standard for assessment of oxygenation and ventilation of the newborn. For the transport team (NETS), it is advisable to obtain and document these measurements (i.e., capillary or venous blood gas plus blood glucose), even in well-adapted neonates with a normal umbilical artery pH, approximately 30 min after birth or prior to transport (for legal reasons). If the newborn infant is depressed, blood gas sampling must be done earlier and should be repeated while the neonate's condition remains critical.
! In extreme acrocyanosis (decreased peripheral perfusion), capillary blood gas analyses and pulse oximetry are unreliable. […]
- Type
- Chapter
- Information
- Neonatal Emergencies , pp. 124 - 130Publisher: Cambridge University PressPrint publication year: 2009