iiPush air out from the syringe iiiOpen stopcock to the newborn ivContinue

Iipush air out from the syringe iiiopen stopcock to

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ii.Push air out from the syringe. iii.Open stopcock to the newborn. iv.Continue withdrawing air. e.Remove the needle when there is no more air to be withdrawn.
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f.If symptomatic ongoing air leak, insert a 22-g angiocatheter in a similar location. i.May further tear the lung and is more likely to kink than the butterfly needle. g.Tubing may be taped to chest and briefly occluded. i.Place tubing in a small bottle of sterile water and release the tubing occlusion. ii.Relieves pressure buildup until patient can be transported. h.During transport, monitor for reaccumulation of the pneumothorax. D.Meconium-stained amniotic fluid 1.Carries a high risk of morbidity a.More common in: i.Postterm newborns ii.Those small for their gestational age iii.Newborns stressed before or during delivery 2.If newborns pass stool before birth, they may inhale the meconium-stained amniotic fluid. a.Airway may become plugged, causing: i.Hypoxia, which can lead to: (a)Atelectasis (b)Persistent pulmonary hypertension (c)Hypoxemia (d)Aspiration pneumonitis ii.Ball-valve effects with an increased risk of pneumothorax b.May cause a delayed drop in pulmonary vascular resistance, which can cause: i.Right-to-left shunting across the foramen ovale or the patent ductus arteriosus (persistent pulmonary hypertension of the newborn) c.To decrease the risk of persistent pulmonary hypertension: i.Ensure a clear airway. ii.Keep newborn warm. iii.Minimize stimulation. iv.Provide supplemental oxygen when necessary. 3.If meconium aspiration occurs, follow closely for signs of deterioration. 4.Assessment and management a.Determine if fluid is thin and green-stained or thick with particulates. b.Assess activity level. i.If crying and vigorous, use standard interventions. ii.If depressed, do not dry or stimulate.. (a)Clear meconium from airway (b)Intubate the trachea. (c)Attach a meconium aspirator and suction catheter to the end of the ET tube. (d)Suction the ET tube while withdrawing the tube from the trachea. (e)Cover the meconium aspirator hole with your finger while suctioning. c.If intubation is unsuccessful and the newborn is bradycardic, continue standard resuscitation per NRP guidelines. i.Start with room air. ii.If hypoxia persists, provide blended oxygen or 100% oxygen to reverse hypoxia.
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(a)Preductal oxygen saturation takes about 10 minutes after birth to reach 90%. iii.If the newborn remains bradycardic after effective PPV, initiate chest compressions and further interventions. iv.Suspect airway occlusion or pneumothorax if the newborn does not respond well to resuscitation. d.Take steps to minimize hypothermia. e.Frequently reassess to ensure the newborn’s condition has not changed. f.When transporting a newborn with these issues, stay in communication with a facility skilled at managing high-risk newborns.
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