Based on the responses to the questions will determine if you have assembled the necessary personnel and equipment.
Is there a heartbeat? Was the fluid clear? Will this be a vaginal or c-section delivery? Will the child be vaccinated after birth?
What is the gestational age? Was amniotic fluid clear? How many babies are expected? Are there any additional risk factors?
What time will the delivery take place? Is this her first child? How many babies are expected?
The number and qualifications of personnel will vary depending on the anticipated risk, the number of babies, and the hospital setting.
Every delivery should be attended by at least one skilled person whose only responsibility is the management of the newborn.
All newborns require rapid initial evaluation. If the answer to any of the initial steps questions is "No" the newborn should be brought to the radiant warmer for initial steps of newborn care.
How much does baby weight? What are the breath sounds? How much amniotic fluid was present at delivery?
What is babies heart rate? How many breaths per minute is baby breathing? Did delayed cord clamping take place?
Does the baby appear to be term? Does the baby have good muscle tone? Is the baby breathing or crying?
If baby is vigorous and term then initial steps are not necessary.
Most likely no
Yes, pulse oximeters are very sensitive and always work
If the baby has a low heart rate place the probe on the left hand and it will get a signal.
Gasping respirations are ineffective breathing and one should proceed directly to PPV.
Gasping respirations are an indication of impending death and comfort measures should be started.
Gasping respirations are an indication to start CPAP with a pressure of 5cmH2O and 100% FiO2
Gasping respirations are ineffective and are treated the same as apnea.
Auscultation of the left side of the chest is the most accurate physical examination method of determining a newborns heart rate. Although pulsations may be felt at the umbilical cord base, palpation is less accurate and may underestimate the true heart rate.
By auscultation of the left side of the chest with a stethoscope
By palpating the umbilical cord for a pulse
By placing baby on an ECG monitor
It is imperative that the babies HR is assessed as quickly and accurately as possible. If newborns HR is less than 100 than PPV should be started immediately.
6 seconds and the number counted should be multiplied by 10
As long as it takes to place a pulse oximeter on a finger of the babies left hand
1 minute- you should listen for the HR for a full minute before reporting it
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