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 2 Spontaneous Vaginal Delivery 42 Week infant Unknown Twins

NRP Neonatal Resuscitation Sample Scenario 2 Spontaneous Vaginal Delivery 42 Week infant Unknown Twins
NRP Neonatal Resuscitation Sample Scenario 2 Spontaneous Vaginal Delivery 42 Week infant Unknown Twins
Item# ISBN-13: 9781581104981

NRP Neonatal Resuscitation Sample Scenario 2 Spontaneous Vaginal Delivery 42 Week infant Unknown Twins

NRP Neonatal Resuscitation Sample Scenario 2

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

You are called to attend a spontaneous vaginal delivery of a 42 week infant with an estimated fetal weight of 4000grms. The mother is G2 P2 45 years old with a history of twins, and her last delivery was by emergency C-section. Mother has been in labor for ten hours and withing the last ten minutes, fetal heart rate tracings have become concerning due to late decelerations. Amniotic fluid is clear. Thin infant required forceps assist at delivery and is placed on the warmer limp, cyanotic and apneic.

The mother remains in labor, and the second smaller baby that no body knew about, is coming right now.

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 20

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 70

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 70

limp

apneic

O2 sat 60%

Bilateral breaths sounds heard and good chest movement.

Continue PPV for 30 more seconds Place OGT



2 Min

Check heart rate and listen to breath sounds

HR 80

limp

apneic

O2 sat 65%

no spontaneous respirations Continue PPV

Titrate 02 Sat according to age in minutes



2 Min 30 Sec

Check heart rate and listen to breath sounds

HR 90

becoming more pink

some muscle tone noted

occasional weak gasps

O2 sat 70%

Continue PPV for 30 more seconds



3 Min

Check heart rate and listen to breath sounds

HR 120

muscle tone improving

becoming more active

O2 sat 80%

regular but slow and weak spontaneous respirations

Continue PPV for 30 more seconds and decrease oxygen concentration slightly



3 Min 30 Sec

Check heart rate and listen to breath sounds

HR 125

regular but slow and weak spontaneous respirations

active but not vigorous

O2 sat 83%

Continue PPV for 30 more seconds and reassess



4 Min

Check heart rate and listen to breath sounds

HR 160

respiratory effort improving

strong and regular spontaneous respirations

more regular 02 sat 86%

color is pink

active and vigorous

Discontinue PPV and administer free flow oxyget

Remove OGT



4 Min 30 Sec

Check heart rate and listen to breath sounds

HR 162

spontaneous strong and regular respirations

active and vigorous

O2 sat 86% and continues to rise

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