25: Neonatal resuscitation in VS .NET Creating PDF-417 2d barcode in VS .NET 25: Neonatal resuscitation

25: Neonatal resuscitation Using Barcode generator for .NET Control to generate, create PDF417 image in Visual Studio .NET applications. interleaved 25 Figure 25. .NET framework PDF-417 2d barcode 9 Position for two handed chest compressions when standing at the side or foot of the baby .

the xiphis ternum on a point one finger s breadth below an imaginary line drawn between the baby s nipples. The compressions should be about one-third of the depth of the chest to the baby s spine (Figure 25.9).

The compressions should be given in a ratio of 3 : 1 with short ventilation breaths. A total of 120 events in a minute should be the aim but the quality of the compression and ventilation is probably more important than the quantity [10]. They should be continued for 30 s and then the baby reassessed.

Hopefully, there will have been an increase in the heart rate and the baby will be becoming pink and active. If not, and one is happy that chest wall movement is effective and compressions are adequate, one should consider the use of drugs after gaining venous access via the insertion of an umbilical venous catheter (UVC). Such action would almost certainly be the domain of the neonatal team, but with more trainees spending some time in neonatal training posts or attending Newborn Life Support courses, it would not be inappropriate for an obstetrician, midwife or anaesthetist with some UVC experience to insert the line.

One would consider using sodium bicarbonate, adrenaline and dextrose as part of the resuscitation. In babies remaining pale and bradycardic, one should always consider blood loss and in such cases, volume (O negative blood) can be life-saving. All this can be summarized in the algorithm shown in Figure 25.

11. This is the 2008 UK Resuscitation Council newborn life support algorithm for the resuscitation of the newborn baby..

Opening the airway Figure 25.10 Placing of head in the neutral position using a chin lift Well, what PDF-417 2d barcode for VS .NET we can assume is that this heart has been too compromised by the episode of intrapartum asphyxia. It has failed to respond to the effective inflation breaths.

This tells us that this baby requires a short (30 s) period of cardiac compressions in order to try and move blood from the pulmonary vasculature into the coronaries so that the oxygen given with successful inflation breaths can get into the coronaries and give the heart the bump-start it needs. Chest compressions are best given with two hands encircling the chest wall. Fingers at the back, thumbs at the front.

The thumbs should be on the lower third of. The neonat e has a relatively large occiput and if the infant is floppy, this often results in the neck flexing the chin onto the chest wall, leading to obstruction of the airway. In such cases, one needs to be able to open the airway using simple manoeuvres. The simplest manoeuvre is the chin lift , which simply puts the newborn baby s head into a neutral position, opening the airway and allowing the baby to take in air if it is making any sort of respiratory effort (Figure 25.

10). Note that in opening the airway, the baby s face should be parallel to the surface on which it is being resuscitated, with the eyes looking straight upwards. This is different from the adult position, where the neck is extended with the patient sniffing the morning air .

Figure 25.10 illustrates the correct position of the newborn baby s head to achieve the neutral position..

25: Neonatal resuscitation Newborn Life Support Dry the baby Remove any wet towels and cover Start the clock or note the time Head in neutral position Assess colour, tone, breathing and heart rate If meconium present and baby breathing well: Do not suction the airway -baby flop py and not breathing well:. If not breathing Open the airway If still not breathing At all stages ask : Do you need HELP Give 5 inflation breaths Safe gas s upply by mask Use a well-fitting mask connected to a pressure-limited gas supply Each inflation breath 2-3 seconds inflation time at 30 cm H2O for a term baby. Consider i Visual Studio .NET PDF 417 nspection and suction before inflation breaths If breathing: Reassess heart rate and monitor baby If heart rate is satisfactory or increasing: Continue ventilation breaths at about 30/min until the baby is breathing adequately If heart rate is satisfactory or increasing: Continue ventilation breaths at about 30/min until baby is breathing adequately.
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