These guidelines are intended for individuals who are charged with the responsibility of carrying out neonatal resuscitation. The guidelines are applicable to neonates who are making the transitional development from life in the uterus to the outside world. They are also relevant for neonates who have finished perinatal transition, and would have to be resuscitated during the first couple of weeks after birth. Why is this important? This is important because about 15% of newborns will require some form of help to be able to breathe on their own. Another 1% requires intense help as far as resuscitation attempts are concerned.
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What are the four prerequisites prior to carrying out neonatal resuscitation?
- Was the baby born following a successful gestation period at term? Is the birth premature?
- After delivery, what is the appearance of the amniotic fluid? Is it clear or has it been contaminated with meconium? The latter is indicative of infection, and which calls for medical attention for the baby.
- Is the baby crying? Are they breathing normally or does the breathing sound difficult and labored?
- What about the muscle tone of the baby? Is muscle tone correct as it should be?
If the answer to all of these questions is in the affirmative, then it is likely that there is little need for neonatal resuscitation. With this however, the baby need not be separated from the mother. The baby will be cleaned up and placed on the mother’s chest before been swaddled to keep warm. During this time, observation will still be ongoing. If the answer to these questions is a no, it is medically sound to subject the infant to the following actions in sequential order:
- Work to ensure that the infant is stabilized this involves making sure that they are warm and dry with their airways
- Carry out ventilation
- Follow this up with compressions to the chest if there will are no changes.
- Administer adrenaline. Depending on the specific case of neonatal resuscitation, there may be need to include volume expansion.
These steps, as mentioned above, are carried out in a sequence. Consequently, the change from one step to another is influenced by three key signs and they include: respiration, the rate of heart beat as well as the color of the baby’s skin. The time period allowed for this observation is 30 seconds in between the procedures. This is sufficient time to establish whether there is need to move to the next step or not.
With meticulous planning and putting different factors into consideration during pregnancy, it is possible to anticipate cases where neonatal resuscitation will be a necessity. In such a case, it is imperative that medical personnel are put in place and the necessary equipment prepared beforehand. The same is applicable to cases where a preterm delivery is expected, meaning that the baby will be born before full gestation period is over. Neonatal resuscitation is a fundamental process in proper health care of newborns.