Look for a response If no increase in heart rate Look for chest movement in Visual Studio .NET Make PDF 417 in Visual Studio .NET Look for a response If no increase in heart rate Look for chest movement

Look for a response If no increase in heart rate Look for chest movement Using Barcode generator for Visual Studio .NET Control to generate, create PDF-417 2d barcode image in .NET framework applications. barcode 128 If no response Recheck head position Apply jaw thrust Repeat inflation breaths Look for a response If no increase in heart rate Look for chest movement If still no response Get help from a secon VS .NET PDF 417 d person To support the airway and/or Inspect the oropharynx and Consider suction and/or Insert an oropharyngeal airway. Try alternative airway opening manoeuvres Repeat inflation breaths Look for a response I PDF 417 for Visual Studio .NET f no increase in heart rate Look for chest movement If the chest is not moving: When the chest is moving Give ventilation breaths. Check heart rate If the heart rate is not detectable or slow (<60).

Recheck head position and Repeat inflation breaths If competent, consider intubation Start chest compressions 3 compressions to each breath If the chest is still .NET PDF 417 not moving:. The airway is the problem Chest compression Com Visual Studio .NET PDF-417 2d barcode pression rate: 120/min Comp/vent ratio: 3:1. If the heart rate is increasing:. Reassess heart rate every 30 seconds Consider venous access and drugs Stop compressions Con PDF417 for .NET framework tinue ventilation breaths at about 30/min until the baby is breathing adequately. Figure 25.11 Newborn Life Support Algorithm 2008 25: Neonatal resuscitation If this fails to allo w air entry, one can consider the jaw thrust manoeuvres described above. Whatever the condition of the baby at birth, it is vital to remember that the baby will be wet and have a large surface area to body mass ratio. These two issues mean that the baby will lose heat very quickly.

A cold, wet baby is much more difficult to resuscitate than a warm, dry baby. For the newborn term baby, it is important that the baby is wiped and dried and wrapped in warm towels as quickly as possible after birth, particularly if it has not established a normal breathing pattern. Remember particularly to dry the head and, if need be, place a hat on the baby s head.

Premature infants are now placed into warming bags undried, which has shown to be an effective method of conserving heat for the baby. The use of a warmer bag is only advocated if the baby will remain under an overhead radiant heater which would allow the child to maintain warmth. If a radiant heater is not available, then even the premature baby should be towelled dry and wrapped in warm, dry towels using a hat in the same way as the term baby.

. their respiration. Mo .NET PDF-417 2d barcode st of the premature babies who are being resuscitated are babies who require stabilization rather than resuscitation [13].

The preterm baby who has undergone the same asphyxial events as the term babies described earlier is not likely to survive, and most of the babies where the neonatal team are involved in the resuscitation are those preterm babies who are born and show signs not only of vitality but also of viability. This whole question may be considered in other parts of this book, but the recent publication by the Nuffield Bioethics Council does give some sensible guidance on which babies should or should not be resuscitated [14]..

Meconium-stained liquor The newborn baby is b .NET framework PDF-417 2d barcode orn with its bowels containing meconium. This is a mixture of sloughed-off cells and bowel secretions formed over the time that the fetus has been developing in utero.

Babies who are nearing term may, in the presence of an asphyxial insult, evacuate their bowels and hence the liquor will appear meconium-stained. From the earlier physiology which we have described (Figure 25.1), it will be understood that if the baby reaches the gasping phase of asphyxia and the liquor contains meconium, then that fetus is very likely to aspirate the meconium into their lungs.

There is little that anyone can do about this meconium even at the time of the delivery, and the job of the resuscitator under such circumstances is to try and prevent any further aspiration of meconium which may be in the nose and the mouth of the newborn infant. The guidance about what to do for a baby born with meconium-stained liquor has become simpler since the advent of the newborn life support algorithms (Figure 25.11).

The baby born in the presence of meconium who is active, pink and crying should be wiped and wrapped in the same way as we have already described, and should be watched for any signs of respiratory distress owing to the meconium which may have been aspirated prior to the delivery. For the baby who is born floppy and not breathing, once the baby has been gently dried and covered with a warmed towel, direct inspection of the oropharynx would be advocated with the use of a laryngoscope and any particulate material present in the mouth should be aspirated using a Yankauer sucker. Once this has been done, the resuscitation can proceed in.

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