Simulation: Precipitous Delivery & Neonatal Resuscitation

1. Simulation: Precipitous Delivery & Neonatal Resuscitation Cindy Hsu, MD, PhD February 19th, 2014

2. Thanks to the West Philly water, you will see one!

3. The Delivery • How to catch the baby • Nuchal cord issues • Wrapped around the neck • Too tight • Prolapse • Delivery of the placenta • Post-partum care

4. http://www.brooksidepress.org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1.htmhttp://www.brooksidepress.org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1.htm

5. The Somersault

6. Neonatal Resuscitation

9. First, ask 3 questions:

10. What about the APGAR?

11. Check the HR at 30 sec How do you check the pulse?What kind of air do you use?

12. Check the HR at 1 min

13. Consider meds Don’t forget about hypothermia and hypoglycemia!

14. Remember the targeted O2sat

15. Meconium • If baby is fine, perform routine care • If patient is under distress, perform deep suction using an ETT and meconium aspirator

16. Intubation ETT LMA:Size 1 is suitable for infants up to 5kg Blade Size 1 for term infants Size 0 for premature infants Size 00 for extremely low birth weight infants

17. Access • IO • Umbilical lines • IO • Umbilical lines

18. Medications • Epinephrine • 0.1 to 0.3mL/kg of 1:10,000 (10-30 mcg/kg) • Can repeat q3-5min if HR < 60 • Glucose • 2mL/kg of D10W • Fluid • 10cc/kg NS over 5-10 minutes, can give 2nd dose

19. Questions?

20. Helpful videos • http://www.youtube.com/watch?v=h-QnKT-moeY • http://academiclifeinem.com/patwari-academy-videos-neonatal-resuscitation/ • http://www.brooksidepress.org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1.htm