bPositioning the newborn iPosition on the back or side with the neck in the

Bpositioning the newborn iposition on the back or

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b.Positioning the newborn i.Position on the back or side with the neck in the sniffing position. ii.Use a small shoulder roll to keep the head in this position. c.Clearing the airway if necessary i.Use a bulb syringe or suction catheter. ii.Turn the head to the side. iii.Suction the mouth before the nose to prevent aspiration. (a)Suctioning hard or deeply can induce a vagal response and bradycardia. iv.Return the head to the sniffing position. d.Drying and stimulating breathing i.Dry the head and body with towels to provide stimulation. ii.Additional tactile stimulation methods include: (a)Slapping/flicking soles of the feet (b)Rubbing gently on the back or trunk iii.Keep appropriate position of the head throughout stimulation. 4.Additional resuscitation steps include: a.Providing supplemental oxygen b.Assisting in ventilation by providing positive pressure c.Intubating
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d.Providing chest compressions e.Administering medications 5.Complications during resuscitation must be anticipated and prepared for. B.Transition from fetus to newborn 1.In utero, the fetus receives oxygen from the placenta. 2.As the fetus is delivered, fetal transition occurs, enabling the newborn to breath. a.First breath triggered by mild hypoxia and hypercapnia from partial occlusion of the umbilical cord during delivery. b.Tactile stimulation and cold stress promote early breathing. c.Pulmonary vascular resistance drops as the lungs fill with air. d.More blood flows to the lungs, picking up oxygen. 3.Delay in pulmonary pressure leads to: a.Delayed transition b.Hypoxia c.Brain injury d.Death 4.Gestation times: a.Preterm—less than 37 completed weeks b.Term—38 to 42 completed weeks c.Post-term—more than 42 weeks C.Arrival of the newborn 1.Obtain a patient history, and prepare the environment and equipment with any available time. a.Key questions to help determine resuscitation and needed equipment include: i.Woman’s age ii.Length of pregnancy iii.Presence and frequency of contractions iv.Presence or absence of fetal movement v.Any pregnancy complications vi.If membranes have ruptured (a)Timing (b)Makeup of fluid vii.Medications being taken 2.90% of newborns are vigorous and at term, and transition well with basic intervention. a.Minimum needs: i.Warm, dry blankets ii.Bulb syringe iii.Two small clamps or ties iv.A pair of clean scissors b.Complications need prompt management. 3.If delivered in the ambulance: a.Cover the foot of the stretcher with clean, warm blankets for the initial stabilization. b.After confirming adequate airway, breathing, and pulse rate, place the newborn on the mother’s chest.
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c.If more extensive resuscitation is necessary, transition newborn to a second ambulance with a neonatal transport incubator. 4.Suction the mouth, then the nose with a bulb syringe once the head is delivered.
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