NRP 8th Edition Questions and Answers Complete Solution

NRP 8th Edition Questions and Answers Complete Solution What is the single most important and effective step in neonatal resuscitation? Ans Ventilation of the newborn's lungs Abnormal Transition Findings Ans -Irregular Breathing, absent breathing, or rapid breathing -Slow or fast heart rate -Decreased Muscle Tone -Pale Skin or Blue Skin -Low oxygen saturation -Low blood pressure NRP algorithm- First Step Ans Antenatal Counselling Team Debriefing Equipment Check After the birth of the baby, what do you ask? Ans 1. Term Gestation? 2. Good Tone? 3. Breathing or crying? FIVE INITIAL STEPS: If you answer NO to any of the three questions (term, tone, breathing) what do you do? Ans Warm Dry Stimulate Position airway Suction if needed Apnea or gasping? HR 100bpm= NO with laboured breathing/cyanosis Ans Position airway, suction if needed Pulse oximeter Oxygen if needed Consider CPAP Apnea or gasping? HR 100bpm= YES Ans PPV Pulse Oximeter Consider Cardiac Monitor HR STILL less than 100bpm= YES Ans Ensure adequate ventilation Consider ETT or laryngeal mask Cardiac Monitor HR 60 bpm? Ans ETT or laryngeal mask Chest compressions Coordinate PPV-100% oxygen UVC HR STILL 60 bpm? Ans IV Epinephrine every 3-5 minutes If still less than 60, consider hypovolemia or pneumothorax Rapid Evaluation Ans Determine if the newborn can remain with the mother or should be moved to the radiant warmer for further evaluation REVIEW: Three questions you ask during rapid evaluation? Ans 1. Term? 2. Good Muscle Tone? 3. Breathing/crying? If the answer is NO to any of these, baby should be brought to radiant warmer. Airway Ans Perform the initial steps to establish an open Airway and support spontaneous respiration Breathing Ans PPV is provided to assist Breathing for babies with apnea or bradycardia Circulation Ans If severe bradycardia persists despite assisted ventilation, Circulation is supported by performing chest compressions coordinated with PPV Drug Ans If severe bradycardia persists despite assisted ventilation and coordinated chest compressions, the Drug Epinephrine is administered as coordinated PPV and chest compressions continue What are the 4 pre-birth questions to ask the provider before every delivery? Ans 1. Expected Gestational Age 2. Is the amniotic fluid clear? 3. Are there any additional Risk Factors? 4. What is our umbilical cord management plan? Equipment Check- Warm Ans -Preheated radiant warmer -Towels/Blankets -Temp Sensor/sensor cover -Hat -Plastic Wrap (32 weeks) -Thermal Mattress (32 weeks) Equipment Check- Clear the airway Ans -Bulb Syringe -10F or 12F Suction catheter attached to wall suction set at 80-100mm Hg -Tracheal Aspirator Equipment Check- Auscultate Ans -Stethoscope Equipment Check- Ventilate Ans -Sets flowmeter to 10 L/min -Sets oxygen blender to 21% (21-30 if less than 35 weeks gestation) -Checks presence/function of PPV devices, including pressure settings and pressure pop-off valves -Sets T-Piece resuscitator at peak inflation pressure (PIP=20-25cm H20 for term, 20cm H20 for preterm) (PEEP= 5 cm H20) -Term and preterm sized masks -Laryngeal mask (size 1) and 5ml syringe -5F or 6F orogastric tube if insertion port present on laryngeal mask -8F orogastric tube and 20ml syringe -Cardiac Monitor and leads