AHA ACLS, BLS, PALS, NRP, PEARS, ACLS EP, PHTLS and Heartsaver First Aid, CPR/AED Saving American Hearts, Inc 6165 Lehman Drive Suite 202 Colorado Springs, Colorado 80918 Catherine Brinkley (719) 551-1222 email: admin@savingamericanhearts.com

NRP Neonatal Resuscitation Sample Scenario 1 Intubation UVC Placement and Epi administration

NRP Neonatal Resuscitation Sample Scenario  1 39 week infant  Intubation UVC Placement and Epi administration
NRP Neonatal Resuscitation Sample Scenario 1 39 week infant Intubation UVC Placement and Epi administration
Item# ISBN-13: 9781581104981

NRP Neonatal Resuscitation Sample Scenario 1 39 week infant Intubation UVC Placement and Epi administration

NRP Neonatal Resuscitation Sample Scenario 1

39 week infant Intubation, UVC Placement and Epi Administration ___________________________________________________________

Please remember to treat this scenario as real as possible. Think out loud and verbalize your thoughts.

You are called to attend an emergency C-Section of a 39 week infant with an estimated fetal weight of 3500 grams. The mother is a G1 P0 35 y/o with a history of poorly controlled Diabetes. The mother was seen in labor and delivery triage due to report of decreased fetal movement. The fetal heart rate on doppler was 50. Amniotic fluid is clear. At delivery, the infant is noted to have a tight nucal cord X 2 requiring surgical reduction.

You have 60 seconds to check and set up your equipment.

BIRTH:

The baby is delivered to the warmer limp, cyanotic and apneic.

Begin warming, drying and stimulating the baby for 30 seconds

30 SEC:

Check heart rate and listen to breath sounds.

HR 50

limp

apneic

Provide EFFECTIVE PPV (Begin with room air) for 30 Seconds Call for additional help Apply pulse ox to right hand/wrist

1 Min

Check heart rate and listen to breath sounds

HR 50

limp

apneic

O2 sat 60%

Students must perform MR SOPA for 30 more seconds

M Mask Readjustment R Reposition airway by adjusting head to "sniffing position" S Suction mouth and then nose O Open mouth slightly and move jaw forward P Increase pressure to achieve chest rise A consider alternate Airway (endotracheal intubation or laryngeal mask airway)

1 Min 30 Sec

Check heart rate and listen to breath sounds

HR 45

limp

apneic

O2 sat 60%

Increase O2 to 100% Begin chest compressions (3 compressions: 1 breath)

Intubate and check tube placement with CO2 detector and listen for bilateral breath sounds

auscultate over epigastric area and watch for chest rise

Prepare and perform UVC placement Administer Epinephrine 0.01-0.03mg/kg via UVC Place OGT Reassess in 1 minute

2 Min 30 Sec

Check heart rate and listen to breath sounds HR 62 limp apneic O2 O2 sat 64% Stop chest compressions Continue PPV and check 02 Sat according to age in minutes Reassess in 30 seconds

3 Min

Check heart rate and listen to breath sounds

HR 85 becoming more pink some muscle tone noted O2 sat 70% no spontaneous respirations Continue PPV for 30 more seconds and reassess

3 Min 30 Sec

Check heart rate and listen to breath sounds HR 98 fair muscle tone noted becoming more active O2 sat 78% occasional spontaneous respirations slow weak Continue PPV for 30 more seconds and decrease oxygen concentration slightly

4 Min

Check heart rate and listen to breath sounds HR 110 slow and weak spontaneous respirations active but not vigorous O2 sat 80% Continue PPV for 30 more seconds and reassess

4 Min 30 Sec

Check heart rate and listen to breath sounds HR 118 respiratory effort improving spontaneous respirations becoming more regular 02 sat 83% color is pink remains active but not vigorous Continue PPV for 30 more seconds and reassess

5 Min

Check heart rate and listen to breath sounds HR 128 spontaneous regular respirations, active and vigorous O2 sat 85% no respiratory distress, O2 sat continues to rise as baby begins to cry

Begin Post Resuscitation care


http://www.savingamericanhearts.com Catherine Brinkley (719) 551-1222 Saving American Hearts, Inc 6165 Lehman Drive Suite 202 Colorado Springs, Colorado 80918 admin@savingamericanhearts.com