Kerala State Drug Formulary.pdf

Paediatrics
RECUSCITATION OF NEWBORN
• Evaluate the neonate at birth for adequacy of respiration, heart
rate and colour.
• Most newborn babies cry immediately at birth. Dry the baby in a
clean warm towel.one of the most accepted objective method to
initate recuscitative procedure is to determine the Apgar score
which is given below
Score 0 1 2
Respiratory None Slow irregular Good, crying
effort
Heart rate/ min Absent 100
Colour of the Blue or pale Body pink, Pink
baby
extremities blue
Muscle tone Flaccid Some flexion Actively moving
the extremities
Reflex
stimulation
(catheter in the
nose)
No response Grimace Cries,coughs or
sneezes
Normal babies have an apgar score of more than 8 at 1 & 5 min.
Apgar score between 4-8 is moderately low while that less than 4 is
very low 5 min apgar score is more important that 1 min apgar score
• If baby has not cried within 15-20 seconds after birth or if baby is
apnoeic or gasping, place the baby on a flat resuscitation table
under a warmer with head slightly extended by 30 degrees.
• Clean the airway by oropharyngeal suction, mouth first, then nose.
° Provide tactile stimulus by flicking the soles.
• Do not slap the baby or hang him upside down.
• If baby is still gasping/apnoeic immediately initiate assisted
ventilation with a bag and mask using oxygen at 2-4 L/min. Use of
oxygen reservoir will enable 100% oxygen administration.
• Count heart rate with a stethoscope for 6 seconds and multiply by
10 to get heart rate in 1 minute.
• If heart rate is less than 60 or fails to rise above 80 after 30 seconds
of assisted ventilation, then initiate external cardiac massage by
chest compression 120 times a minute. For every 2 chest
compression one ventilatory breath is given.
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