L.If prolonged bag-mask ventilation (more than 5 to 10 minutes) is used, gastric decompression with an orogastric tube is indicated if abdominal distention impedes ventilation or if there is a diaphragmatic hernia or gastrointestinal congenital anomaly. M.Perform chest compressions if the pulse rate remains below 60 beats/min despite positioning, clearing airway, drying and stimulation, and 30 seconds of effective positive-pressure ventilation. N.Emergent vascular access is necessary if fluid administration is needed for circulation support or if resuscitation medications or therapeutic drugs be given IV. Newborn vascular access is via the umbilical cord. O.Most newborns are resuscitated with effective ventilator support, but medications may be needed for bradycardia, low blood volume, acidosis, respiratory depression secondary to narcotics, and hypoglycemia. Neonatal medication doses are based on weight. P.Transport to the nearest facility once the newborn is stabilized as much as possible.
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Q.Ongoing communication with family is necessary. Do not be specific about survival statistics. If an answer is not available from prehospital personnel, connect the family with those who can answer their questions. R.Bradycardia in a newborn is usually from hypoxia, which can normally be reversed with effective positive-pressure ventilation. If caused by tension pneumothorax, a needle decompression is necessary. If ventilation and chest compressions do not improve bradycardia, administer epinephrine via and IV line or ET tube. S.There is a high risk of morbidity if a newborn is delivered through meconium-stained amniotic fluid. If depressed, do not dry or stimulate. Instead, clear the airway of meconium, intubate the trachea, attach a meconium aspirator and suction catheter to the end of the endotracheal tube, and suction the ET tube while withdrawing the tube from the trachea. T.Diaphragmatic hernia is an abnormal opening in the diaphragm. If a newborn has this condition and positive-pressure ventilation is needed, endotracheal intubation along with an orogastric tube will be necessary to minimize intestinal distention. Surgical correction is required. U.If born before 37 weeks gestation, newborns are considered premature. Provide cardiorespiratory support and a thermoneutral environment. V.Seizures are distinctive of neurologic disease in the newborn. Evaluate prenatal and birth history, and perform a careful physical exam. Consult with medical control before administering anticonvulsant medication. W.Non-bilious vomiting is common in newborns. Keep the face turned to one side to prevent further aspiration. Suction or clear vomitus from the airway with a suction catheter or bulb. Ensure adequate oxygenation and consider fluid resuscitation. Transport on his or her side.
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