Delivering Freeflow Oxygen v Oxygen mask v Flowinflating

Delivering Free-flow Oxygen v. Oxygen mask v. Flow-inflating bag and v. T-piece resuscitator v. Oxygen tubing mask 1

Free-flow Oxygen Given Via Oxygen Mask

Free-flow Oxygen Given Via Oxygen Mask

Free-flow Oxygen Given Via T-piece Resuscitator

Free-flow Oxygen Given Via Oxygen Tubing

Free-flow Oxygen Given Via Oxygen Tubing

Types of Positive. Pressure Devices � Self-inflating bag � Flow-inflating bag (anesthesia bag) Types of Positive� T-piece resuscitator Pressure Devices

Self-inflating Bag

Self-inflating Bag

Flow-inflating Bag

T-piece Resuscitator

Safety Features: Self-inflating Bags With Pressure-release Valve

Safety Features: Flow-inflating Bag

Safety Features: T-piece Resuscitator

Resuscitation Masks �Rim - Cushioned - Non-cushioned �Shape - Round - Anatomically shaped Resuscitation �Size Masks - Small - Large

Resuscitation Masks: Round Shape Disadvantages �If the correct size is not selected, a seal can not form �If the mask is too large, eye damage may develop

Resuscitation Masks: Anatomically Shaped Advantages � Easier to obtain a seal � Less chance of eye damage

Resuscitation Masks Size �Small �Large Mask should cover �Tip of chin �Mouth �Nose

Resuscitation Masks: Size The correct size will cover the tip of the chin, the mouth, and the nose but not the eyes. �Too large → Eye damage �Too small → Will not cover the mouth and nose and may occlude the nose.

Size of Bag v. Bags used for newborns should have a volume of 200 to 750 m. L. Term neonates only require 15 to 25 ml with each ventilation (5 -8 m. L/kg).

Preparation Checklist Before beginning PPV: �Select appropriate-sized mask �Be sure airway is clear �Position baby’s head �Position yourself at baby’s side or head

Positioning Mask on Face

Ventilation Rate � 40 -60 breaths per minute

Signs of Improvement is indicated by the following signs: �Increasing heart rate �Improving color �Spontaneous breathing Signs of �Improving muscle tone Improvement

Infant Not Improving and Chest Not Adequately Expanding • Possible causes • Inadequate seal • Blocked airway • Inadequate pressure 29

Causes and Solutions for Inadequate Chest Expansion Conditions Actions 1. Inadequate Reapply mask seal to face and lift the jaw forward.

Causes and Solutions for Inadequate Chest Expansion �Reapply mask to face

Causes and Solutions for Inadequate Chest Expansion �Lift the jaw forward

Causes and Solutions for Inadequate Chest Expansion Conditions 2. Blocked airway Actions Reposition the head. Check for secretions; suction if necessary. Ventilate with the newborn’s mouth slightly open.

Causes and Solutions for Inadequate Chest Expansion Conditions 3. Inadequate pressure Actions Increase pressure until there is a perceptible movement of the chest. Consider endotracheal intubation.

Continued Positive-Pressure Ventilation Orogastric tube should be inserted to relieve gastric distention Gastric distention may �Elevate diaphragm, preventing full lung expansion �Cause regurgitation and aspiration

Continued PPV

Insertion of Orogastric Tube Equipment � 8 F feeding tube � 20 -m. L syringe

Insertion of Orogastric Tube Measuring correct length

Insertion of Orogastric Tube �Insert tube through mouth. Resume ventilation �Attach 20 -m. L syringe and aspirate gently �Remove syringe and leave Insertion of to Orogastric tube end open air Tube �Tape tube to newborn’s cheek