Saturday, 15 August 2015

Resuscitation of the Newborn



Marked changes in the cardiovascular and respiratory systems occur at birth . The cardiovascular system undergoes a transition from fetal to neonatal circulation. The respiratory system, essentially non functioning in uteri, must suddenly initiate and maintain oxygenation and ventilation. The aim of resuscitation is to restore and support cardiopulmonary function.

The vast majority of neonates require no resuscitation beyond maintenance of temperature, suctioning of airway and mild stimulation. Only a small number of neonates require further intervention, and most of these respond to administration of a high concentration of inspired oxygen and ventilation with bag and mask. A few newborns who are severely asphyxiated may require chest compressions, and even fewer need resuscitation medications.

PRESENTED BELOW:
An inverted pyramid reflecting relative frequencies of neonatal resuscitation efforts for the the newborn who does not have meconium stained amniotic fluid. Note that a majority of newborns respond to simple measures.

Assess and support : Temperature (warm and dry)
                                    Airway (position and suction)
                                    Breathing (stimulate to cry)
                                    Circulation (heart rate and colour)

Frequently needed                                                  
Dry, Warm, Position
                                                                                    Suction, Stimulate

                                                                                            Oxygen

                                                                          Establish Effective Ventilation
                                                                                   Bag - valve mask
                                                                           Endotracheal Intubation

                                                                                             Chest
                                                                                    Compressions

Infrequently needed                                                       Medications
                                                                                                 tions
SCHEMATIC REPRESENTATION OF RESUSCITATION OF THE NEWBORN


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