Contents Chapter Topic Page Neonatology Respiratory Cardiology

Meconium stained liquor:
Meconium in amniotic fluid
Suction the mouth, pharynx and nose at delivery of
the head (before delivery of shoulders) using a 10F
or larger suction catheter.
Tracheal suctioning can be done by
Infant vigorous?
- Good respiration
- HR > 100/min
- Good muscle tone
NO
As soon as the infant is on radiant warmer and
before drying:
• Residual meconium in the hypopharynx
should be removed by suctioning under direct
vision.
• The trachea must be intubated and meconium
suctioned from the lower airway and repeated
until clear.
Resuscitate as
needed
a) Applying suction (100 mmHg) directly to the ET tube with a meconium
aspirator adapter. Continuous suction is applied to the tube as it is
withdrawn. Reintubation followed by suctioning should be repeated until
returns are nearly free of meconium. DO NOT attempt to suction thick
meconium with a suction catheter through an ET tube (catheter size too
small).
b) Alternatively use a large bore suction catheter (at least 12F) with an end
hole and side hole inserted directly into the trachea. The catheter is rotated
and continuous suction applied as it is being withdrawn. This is the
recommended method in places with no meconium aspirator adapter.
Continuous suction should not be applied for longer than 3 – 5 seconds.
If baby is severely depressed with heart rate < 60/min., positive pressure
ventilation may be needed even if some meconium remains in the airway.
After tracheal suctioning, the stomach should be suctioned to prevent aspiration of
meconium containing gastric contents. This should be done when the child is fully
resuscitated and vital signs are stable.
YES