What do you mean by neonatal resuscitation?
Neonatal resuscitation (CPR) provides oxygen, stimulates breathing and gets the heart to start pumping normally. Most premature babies and babies with certain congenital conditions require extensive resuscitation.
Neonatal resuscitation is a procedure performed if a newborn infant does not start breathing spontaneously immediately after birth. Neonatal resuscitation provides oxygen, stimulates breathing and gets the heart to start pumping normally.
A majority of babies start breathing on their own and need only routine neonatal care. Approximately 10% of newborn require some assistance for the transition from fetus to newborn, and about 1% require extensive resuscitative measures.
Most premature babies and babies with certain congenital conditions require extensive resuscitation. What are the steps in neonatal resuscitation? Preparation Readiness and capability in handling a potential emergency during delivery are two most important components of successful neonatal resuscitation. Preparation for neonatal resuscitation includes the following:
Skilled personnel: Medical personnel in the delivery room must be skilled in neonatal resuscitation. The Neonatal Resuscitation Program is a highly respected training program for delivery room personnel, developed jointly by the American Academy of Pediatrics (AAP) and the American Heart Association (AHA).
Resuscitation equipment: The delivery room should be equipped with all the tools required for neonatal resuscitation.
Anticipation of potential problems: Anticipation and identification of the risk factors, though not always possible, is greatly helpful in successful neonatal resuscitation.
Rapid assessment: The infant must be rapidly assessed to determine need for resuscitation. Resuscitation must be considered and/or initiated if the answer is “no” to any of the following questions:
Is the baby born after full gestation term?
Is the amniotic fluid clear of meconium (baby’s first stool) and signs of infection?
Is the baby breathing and crying?
Does the baby have good muscle tone?
The initial steps in neonatal resuscitation include:
Maintaining adequate warmth during neonatal resuscitation is of primary importance. Loss of heat increases the newborn’s metabolic rate in order to generate heat. As a result, the oxygen requirement also is driven up, which is dangerous in a baby already under respiratory distress.
Some of the measures taken to keep the baby warm include the following:
Using pre-warmed towels to dry the baby
Using pre-warmed blankets and bed warmers
Maintaining a room temperature of 75 F to 80 F based on the baby’s gestational age and birth weight.
Using heat-resistant food grade plastic wrap around premature infants with low birthweight
Using an adequately pre-warmed incubator
The AAP and AHA state that the baby’s body temperature should be maintained at 97.7 F (36.5 C). Temperature is recorded as soon as possible after birth and every 10 to 15 minutes thereafter.
The newborn is properly positioned to keep the airway (trachea) open. The mouth and nose are gently suctioned to remove any amniotic fluid or meconium aspirated during delivery.
Drying and suctioning is often sufficient stimulation for the newborn to start breathing. If more stimulation is required, gently slapping the soles of the feet or rubbing the back can initiate breathing.
The initial steps should be completed with an evaluation of the baby’s respiratory rate, heart rate and skin color, within 30 seconds after birth. If the baby is pink, breathing normally, and has a heart rate of over 100 beats per minute (BPM), no further intervention is required. The baby stays under observation and receives routine neonatal care.
If the newborn does not meet the criteria for routine care after the initial steps, supplemental oxygen with assisted ventilation is initiated within the next 30 seconds.