Neonatal resuscitation
Neonatal Resuscitation
85% of delivered newborn need only basic
newborn care.
10% of cases need some help for survival.
Only 5% newborn need immediate life
support measures, so if not provided within
first minute called Golden minute of life,
newborn mortality or morbidity will occur.
Equipments
Two pieces of sterile cloth (one for cleaning
and another for wrapping the baby)
Clock with seconds hand.
Sterile gloves.
Sterile blade for cutting umbilical cord.
Umbilical cord clamp.
Radiant warmer
Oxygen (central supply or cylinder)
Suction device (mucus extractor or central
suction facility
At delivery
Ensure the delivery room is warm
(25 degree C. with no draughts).
Dry the baby immediately and
remove the wet cloth.
Keep the baby close to
mother( ideally skin to skin contact)
Postpone bathing/sponging for 24hrs
After delivery
Breast Feeding
Effective sucking:
Infant takes several deep sucks
followed by swallowing and the
pauses
Ineffective sucking:
Infant sucks for short time but tries
out and is unable to continue for long
time.
Danger signs
Lethargy
Breathing difficulty
Temperature instability
Failure to pass urine/meconium in 24hrs/48hrs
Vomiting
Diarrhea
Cyanosis
Jaundice
Abdominal distention
Convulsions
Bleeding
Excessive weight loss.
Respiratory care
Respiratory
distress
syndrome
Congenital
pneumonia
Miscellaneous
causes:
hypothermia ,
TTN
Meconium
aspiration
syndrome
Pneumonia
Asphyxia
RECOGNITION
Tachypnea (RR >60)
Chest indrwaing, Inter and subcostal
retraction.
Grunting
Apnea/Gasping are signs of extreme
illness.
Cyanosis/Need for oxygen to
maintain saturation.
Supportive Care
Temperature
Maintenance of temperature
Cold stress:
Remove the baby from cold
environment, remove cold/wet
clothes.
Give Kangaroo mother care to baby.
Normally every baby must be given
KMC as it has many benefits despite
preventing from hypothermia.
KMC procedure
Infection in newborn
Superficial infection
Omphalitis:- infection of umbilicus.
LOCAL INFECTION
Redness around umbilicus less
than 1 cm and absence of signs
of sepsis
Treatment
Local cleaning with
antiseptic lotion followed by
application of gentian violet
0.5% qid till redness subsides.
SEVERE INFECTION
Redness around umbilicus
greater than 1cm and signs of
sepsis.
Treatment
Same as for local infection + IV
antibiotics.
Immunization
All neonates should be immunized at
birth or with 2 days with BCG OPV
and Hep B vaccines.
All care givers of attends should be
advised about follow up vaccination
as per vaccination schedule.
SUMMARY
Neonatal Hyperbilirubnemia
Definition :Increase in level of bilirubin
in circulation.
Occurs as a result of
imbalance between bilirubin
production and excretion.
Clinical assessment
Investigations
Treatment of Unconjugated
Hyperbilirubnemia
Phtotherapy
Exchange Transfusion.
IVIG in Case of incompatibilities.
New modalities like Tin porphyrins,
Phenobarbitone in special cases.
Prevention