7 STEPS ON NEONATAL RESUS

Question 1

STEP 1

Answer 1

• Is the baby term?
• Good tone?
• Breathing?

Question 2

STEP 2

Answer 2

• Start clock
• Provide warmth
• Clear airway
• Dry and stimulate or put in plastic bag if preterm

Question 3

STEP 3

Answer 3

Assess breathing, HR and sats/colour
- If gasping, apnoeic or HR <100

Question 4

STEP 4

Answer 4

• Start ventilation with room air at 30-40 breaths/min for term
• Use oxygen at 30-40% if preterm
• Connect pulse oximeter
• Ensure chest rise»_space; NMOVING

Question 5

BAGING AND SATURATION

Answer 5

Use blended oxygen if possible. Bag with no air= 21%. Bag with air= 40%. Bag with
reservoir= 100%.
Normal pre-ductal sats after birth:
➢ 1min >60%
➢ 2min >65%
➢ 3min >70%
➢ 4min >75%
➢ 5min >80%
➢ <10min 90-95%

Question 6

STEP 5

Answer 6

Assess breathing, HR and sats/colour every 30-60 Seconds
- If HR 60bpm<100bpm
➢ Continue ventilation with oxygen as required
- If HR <60bpm
➢ Continue ventilation with supplemental oxygen as require
➢ Start compressions and consider intubation
➢ 1:3, each cycle taking 2 seconds

Question 7

STEP 6

Answer 7

• Reassess breathing, HR and sats/colour
• If HR <60pbm
  ➢ Continue ventilation and chest compressions

Question 8

STEP 7

Answer 8

• Intubation and drugs
  ➢ 0.1-0.3 ml/kg Adrenaline IV (1:10 000 dilution with saline), peripheral line
  or UVC or ET tube last resort (1ml/kg adrenaline ETT 1:10 000 dilution)
  ➢ May repeat adrenaline after 3-5mins
  ➢ Correct hypovolaemia in necessary: 10ml/kg normal saline IV over 5-
  10min
  ➢ Consider pneumothorax and check glucose

Question 9

UVC

Answer 9

• Emergency only because it can cause sepsis
• Cord tie
• Cut 2cm
• Identify vein
• Flush 6 or 8 tube
• Insert 5cm

Question 10

WHEN TO STOP RESUS

Answer 10

• 10mins no output
• No spontaneous respiration after 30mins