Delivery Room Management (<1500 Gms OR < 32 wks gestation)

1. Delivery Room Management(<1500 Gms OR < 32 wks gestation) OBTAIN PERINATAL INFOMRATIONIF POSSIBLE DISCUSS WITH MD/ARNP/RT/RN This guideline is an adjunct to routine NRP recommendations for management of the newborn in the delivery system Dry and stimulateSuction Oral and Nasopharynx DELIVERYROOM yes Infant < 750 gmOR < 26 wks More than 26 wks gest, and Spontaneous Respirations no yes yes Bag and Mask PPV, PIP 20-25 cm H2O pressure(Bag with Neo-Puff) Heart Rate > 100,O2 Sat > 88%Comfortable Resp,In Room Air HR > 100 AND O2 Sat > 88% Good Resp Effort/Compliant Chest wall yes If HR < 100 OrO2 Sat < 88% Good Response no Yes Bubble CPAP +5 no yes INTUBATE, ventilate with PIP < 25 cm H2O(Bag with Neo-Puff)SURFACTANTAdministration INTUBATE, ventilate with PIP < 25 cm H2O pressure(Bag with Neo-Puff). HR> 100, O2 Sat. > 88%on ANY FiO2,& sustained spontaneous respiratory effort HR > 100 and O2 Sat > 88% yes yes SURFACTANT Transport to NICU after stabilizationBag with Neo-Puff Transport to NICU, on Room Air Transport to NICUon Bubble CPAP Transport to NICUBag With Neo-Puff