Skills Lab - Resusitasi Neonatus

Summary

This video features Dr. Gina Puspita, a pediatrician, guiding viewers through the essential steps of neonatal resuscitation. Beginning with preparation, she explains the necessary tools and materials, including warmth, respiratory and circulatory support, ventilation devices, and transport equipment. The video demonstrates initial assessment, airway management, positive pressure ventilation, intubation, and chest compressions for newborns with low heart rates. It emphasizes careful monitoring of heart rate, breathing, oxygen saturation, and muscle tone. The tutorial also covers post-resuscitation care, parental education, and safe transport to the neonatal unit. This comprehensive guide equips healthcare providers with practical knowledge to respond effectively during newborn emergencies.

Takeaways

• 😀 Neonatal resuscitation begins with the preparation of tools and materials like an infant warmer, cloths, a hat, and a plastic bag if the baby has low birth weight.
• 😀 RW (respiratory) support tools include a negative pressure suction, a catheter for clearing airways, and a meconium aspirator in cases of meconium aspiration.
• 😀 Ventilation support is provided with an ambu bag and mask (or thin resuscitator), along with intubation tools like endotracheal tubes and laryngoscopes, depending on the baby's weight.
• 😀 For circulatory support, adrenaline is the primary drug used, followed by isotonic NaCl fluid and UMB catheter for fluid/medication administration.
• 😀 To monitor the baby during resuscitation, pulse oximetry is crucial for accurate saturation and heart rate readings.
• 😀 After the baby is delivered, check the baby’s breathing, muscle tone, and cry. Position the baby correctly and assess for airway clearance before proceeding with ventilation if needed.
• 😀 If heart rate is below 40 beats per minute, positive pressure ventilation (PPV) should be started immediately, using an ambu bag set to 21% oxygen for term babies and higher oxygen for premature ones.
• 😀 If the chest wall does not expand during ventilation, adjust the technique by repositioning the baby or increasing the pressure.
• 😀 Intubation may be required if there is no improvement in chest expansion after several adjustments. The correct ET tube size should be chosen based on the baby's weight.
• 😀 In cases where the baby’s heart rate remains low (under 40 bpm), chest compressions must be started, with a 90:30 compression-to-breaths ratio for 60 seconds, followed by an evaluation.
• 😀 After successful resuscitation, transport the baby to an incubator, ensuring proper monitoring of blood sugar, temperature, and blood pressure, and provide parents with thorough education about the process.

Q & A

What is the first step in neonatal resuscitation?

The first step in neonatal resuscitation is the preparation of tools and materials, such as ensuring the availability of a warmer, clothing, and essential resuscitation equipment.

What tools and materials are necessary for warming a newborn during resuscitation?

For warming a newborn, you need an infant warmer, three cloths (for the base, seat, and receiving the baby), a baby hat, and if the baby weighs below 1500 grams, a plastic bag.

How should a newborn be positioned during resuscitation?

The newborn should be positioned in a semi-extension with the shoulder placed on a pillow to help open the airway and facilitate proper ventilation.

What is the recommended oxygen fraction for a term baby during positive pressure ventilation (PPV)?

For a term baby, the recommended oxygen fraction is 21% during positive pressure ventilation, with adjustments made depending on the baby's condition.

What is the difference in oxygen fraction for premature babies during resuscitation?

For premature babies, the oxygen fraction should be between 30% and 40%, depending on the specific needs and conditions of the baby.

What equipment is used for ventilation support in neonatal resuscitation?

The primary equipment used for ventilation support includes an Ambu bag (self-expanding resuscitation bag) and a mask. In some hospitals, a thin resuscitator can also be used as an alternative.

How do you assess the heart rate of a newborn during resuscitation?

The heart rate can be assessed by counting the beats over 6 seconds and then multiplying by 10, or by measuring through the vena cava or using a pulse oximeter if available.

What should be done if the baby's heart rate is below 40 beats per minute during resuscitation?

If the heart rate is below 40 beats per minute, positive pressure ventilation (PPV) should be continued, and if necessary, chest compressions should be performed.

What is the procedure for chest compressions in a newborn during resuscitation?

For chest compressions, place two fingers on the lower third of the sternum and perform compressions at a rate of 90 compressions and 30 breaths every 60 seconds.

What is the role of intubation in neonatal resuscitation?

Intubation is considered when the airway is not effectively managed with PPV, or if ventilation is insufficient. The correct endotracheal tube size is based on the newborn's weight, typically starting with size 3.0 for term babies.