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Review of CPR for newborns [2005 AHA]

Review of CPR for newborns [2005 AHA]. By Elizabeth Kelley Buzbee A.A.S., R.R.T.-N.P.S., R.C.P. question. You are called to L & D to assess a newborn for CPR. List the 4 questions you ask yourself about the baby. answer. Was this a full term gestation?

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Review of CPR for newborns [2005 AHA]

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  1. Review of CPR for newborns [2005 AHA] By Elizabeth Kelley Buzbee A.A.S., R.R.T.-N.P.S., R.C.P.

  2. question • You are called to L & D to assess a newborn for CPR. • List the 4 questions you ask yourself about the baby.

  3. answer • Was this a full term gestation? • Is the amniotic fluid clear and normal? • Is the baby crying or breathing? • Is there good Muscle tone?

  4. question • Your baby is a 27 weeker who is 1100 grams. • She is floppy with a heart rate of 88 bpm and gasping • She has an Sp02 of 75% • What do you do?

  5. answer • Clear the airway, Establish an airway and mask bag at 100% at a rate of 40-60 bpm • Reassess the HR in 30 seconds

  6. question • After mask bagging for 30 seconds, you see that the baby’s chest rises with the bagging at a PIP 25 cwp and that the HR is now 45. • What do you do at this point?

  7. answer • Start chest compressions at a rate of 90 bpm with RR 30 1:3 ratio • Reassess in 30 seconds • Go ahead and intubate with a 3.0 endotracheal tube.

  8. question • When the doctor intubates the patient with a 3.0 endotracheal tube he pushes it to the 9 cm depth. • What do you do [someone else is still doing compressions]

  9. answer • Check BBS with stethoscope over the axillary in both left and right. • Check the Sp02 • If you hear some gross leaking, push the ET-tube down to the 10 cm mark [3.0 ET tube] • Re-check the BBS & Sp02 and tape the tube

  10. question • You have been doing chest compressions/ventilation at 1:3 ratio for 30 seconds and when you stop compressions you note that the baby’s HR is now 110. • What do you do now?

  11. answer • Stop compressions, keep bagging at 40-60 bpm at 100%

  12. question • The ET tube is in good position based on assessment of the BBS, but you notice that the Sp02 on 100% bagging at PIP 24 is only 89%. • What do you do?

  13. answer • In the first 30 minutes of life. a Sp02 about 90% is acceptable at this time. • Because the baby most likely has IRDS type I we could add a PEEP valve to the bag and place baby on PEEP 5 cwp.

  14. question • You notice that the baby’s belly is getting quite large and tight. • What do you do?

  15. answer • Ask the nurse to place a naso-gastric tube to vent the excessive air from the stomach that is causing a restrictive defect

  16. question • If the baby had not had a good pulse after a few minutes of chest compressions, what would you do?

  17. answer • If HR is still less than 60 bpm, continue CPR & • administer epinephrine [1:10,000] by IV .01 to .03 mg/kg

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