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ASHPHYXIA

By:
Dr. Abdurachman Sukadi, dr.,SpAK
ASPHYXIA
DEFINITION:

Progressive hypoxia, acumulation of CO2 and


acidemia

CLASSIFICATION:
Without asphyxia (APGAR score 8-10)
Mild- moderate (APGAR score 4-7)
Severe (APGAR score 0-3)
ETIOLOGI

Pre/intra natal : Placental insufficiency


Post natal: secondary of lung insufficiency
heat disease
Gambar no 5
RESUSCITATION
Place under radiant heater
Dry thoroughly
remove wet line
Position
Suction mouth then nose
Tactile stimulation Evaluate respiration

None or gasping Spontaneous

< 100 x/m


PPV-O2, 100%, 15-30 Evaluate Heart rate

> 100 x/m


pink or peripheral Black
cyanosis

observe and monitor O2


Evaluation heart rate
Evaluate Heart Rate

< 60 x/m 60 - 100 x/m > 100 x/m


- Continue HR not increasing HR increasing Watch for
ventilation - Continue Spontaneous
ventilation - continue respiration
- Check - Chest ventilation
compression compression Then discontinue
if HR < 80 x/m Ventilation

Initial medication if
HR < 80 x/m, after
30 PPV - 02 100%
&
Chest compression
MEDICATION FOR RESUSCITATION
HR zero
or
HR below 80/min after 30 seconds
PPV and chest compressions

Give May be repeated


epinephrine every 3-5 minutes
if required

HR Yes
above Discontinue
100 medication
?

No
HR < 100

Prolonged are that Evidence or suspicion


does not response to of acute blood loss with
other therapy signs of hypovolemia May be repeated
if signs of
Give Give hypovolemiapersist
sodium bicarbonate volume expander

Evidence
of continuing
depression ?

Consider other caused, eg.


- Pneumothorax
- Diaphragmatic hernia
- Persistent pulmonary hypertension
Consider stating dopamine
Consultation
Meconium in amniotic fluid

Intrapartum suctioning of
mouth, pharynx, and nose

Thin Thick

Infant Infant
active depressed

Suction
Observe trachea

Resuscitate PRN Resuscitate PRN


One over the other 2
Chest3
Epiglottis