Neonatal resuscitate | Abstract

Journal of Clinical Nursing and Practice


Neonatal resuscitate

Raktima Chakrabarti

Most infants adapt well after birth to extra-uterine life without any active resuscitation. 85% infants breathe spontaneously, a further 10% respond after drying, temperature maintenance, stimulation, and airway opening manoeuvres. Only 5 % neonates receive positive pressure ventilation. Only 0.2-4 % babies need to be intubated at the time of birth. Less than 0.3 % babies need chest compression and only 0.05% babies need adrenaline.

For a successful resuscitation a well-orchestrated team is required containing well trained nurse and neonatologist with proper preparation of equipment is required. . 1). As a guide,

•          Personnel competent in new born life support should be available for every delivery.

•          If intervention is required, there should be personnel available whose sole responsibility is to care     for the infant.

•          A process should be in place for rapidly mobilising a team with sufficient resuscitation skills for any   birth specifically where risk factors are present.

There are some rent changes in the guidelines of resuscitation:

•          Delayed cord clamping

•          Special care for infants with meconium stained liqor, specifically who are non-vigorous

•          If facemask is not useful and intubation is difficult, there is a role of laryngeal mask airway

•          Gradual increase of inflation pressure has a role in initiation of respiration where airway is open.

•          There is a role of air/oxygen in preterm delivery

•          100% oxygen is required with chest compression

•          Intraosseus route has a role in emergency access of medicines and fluid

•          Adrenaline and 10% dextrose are important medicines in the resuscitation kit

•          Failure to respond despite 10-20 minutes of intensive resuscitation is associated with high risk of poor outcome.