Simulation Precipitous Delivery Neonatal Resuscitation Cindy Hsu MD

Simulation: Precipitous Delivery & Neonatal Resuscitation Cindy Hsu, MD, Ph. D February 19 th, 2014

Thanks to the West Philly water, you will see one!

The Delivery • How to catch the baby • Nuchal cord issues – Wrapped around the neck – Too tight – Prolapse • Delivery of the placenta • Post-partum care

http: //www. brooksidepress. org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1. htm

The Somersault

Neonatal Resuscitation

First, ask 3 questions:

What about the APGAR?

Check the HR at 30 sec How do you check the pulse? What kind of air do you use?

Check the HR at 1 min

Consider meds Don’t forget about hypothermia and hypoglycemia!

Remember the targeted O 2 sat

Meconium • If baby is fine, perform routine care • If patient is under distress, perform deep suction using an ETT and meconium aspirator

Intubation ETT LMA: Size 1 is suitable for infants up to 5 kg Blade Size 1 for term infants Size 0 for premature infants Size 00 for extremely low birth weight infants

Access • IO • Umbilical lines

Medications • Epinephrine – 0. 1 to 0. 3 m. L/kg of 1: 10, 000 (10 -30 mcg/kg) – Can repeat q 3 -5 min if HR < 60 • Glucose – 2 m. L/kg of D 10 W • Fluid – 10 cc/kg NS over 5 -10 minutes, can give 2 nd dose

Questions?

Helpful videos • http: //www. youtube. com/watch? v=h-Qn. KTmoe. Y • http: //academiclifeinem. com/patwariacademy-videos-neonatal-resuscitation/ • http: //www. brooksidepress. org/Products/O bstetric_and_Newborn_Care_II/lesson_3_ Section_1. htm