NEWBORN

RESUSCITATION

(NEWBORN CPR)
BSN 12C

MADELINE N. GERZON, RN, MM

Clinical Instructor
Davao Doctors College
 Objectives

By the end of this session, students will be able

to:
1. Define Newborn CPR
2. Determine conditions of mother that warrant
newborn CPR immediately after delivery
3. Distinguish newborn that requires CPR
(resuscitation) through careful assessment
4. Identify equipment to perform newborn CPR
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Objectives

By the end of this session, students will be

able to:
5. Familiarize the skills in newborn CPR
(resuscitation)
6. Discuss relevant nursing responsibilities
during newborn CPR
7. Perform return-demonstration of newborn
CPR.

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INTRODUCTION
Topics
 Newborns & Neonates
 High-Risk Newborn Patients
 APGAR Scoring
 Newborn Resuscitation
 Special Situations
Introduction

Neonate
An infant from the time of birth to
one month of age

Newborn
A baby in the first few hours of its life,
also known as newly born infant
Source: World Health Organization, 2010)
 Introduction

• Neonate: 0-28
days
• Newly born:
Immediately at
birth when fetus is
physiologically
converting to
newborn life
Source: the Pediatric Emergency Medicine Resource
Term newborn
HIGH RISK NEWBORN
CONDITIONS THAT WARRANT CPR?
 Urgent Maternal History

• Is the baby more than four weeks early?

• If the water has broken, was the fluid

brownish or greenish in color?

• Multiple births expected?

• Narcotic drugs recently?

Brief Resuscitation-Oriented History
HIGH RISK-NEWBORN
Epidemiology
 Approx. 6% of field deliveries require
life support.
 The incidence of complications
increases as the birth weight
decreases.
 Approx. 80% of newborns weighing
1500 g (3 pounds, 5 ounces) at birth
require resuscitation.
Pathophysiology

• Dramatic changes occur within the

newborn to prepare it for extrauterine
life.

• Fluid in the fetal lungs will be forced out

of the lungs during delivery by
compression of the chest and by entry
of air into the lungs.
Factors that stimulate the baby’s
first breath…
 Mild acidosis
 Initiation of stretch reflexes in the lungs
 Hypoxia
 Hypothermia
Hemodynamic changes
in the newborn at birth
Assessment
 Normal heart rate 150–180 per minute.
Slowing to 130–140 thereafter.
A pulse less than 100 indicates distress.

 Normal respiratory rate 40–60 per minute.

 Evaluate skin color as well.

 Use the APGAR score.

APGAR Scale
What should you expect?
Birth Asphyxia
Birth Asphyxia - the failure
to initiate and sustain
breathing at birth
 Management of Birth
Asphyxia

1)Basic Resuscitation
2)Advanced
Resuscitation
Nursing Responsibilities!!!!!
 TWO SCENARIOS

• Baby-out

• Baby about to be delivered

 Preparation for Delivery

• Assume that the infant will be depressed

• Locate all necessary equipment in
advance
 Equipment and supplies

Check that all needed equipment and instruments

for delivery care, essential maternal and newborn
care, newborn resuscitation, and adult resuscitation
are:
• Available
• In good working order
• Clean/sterile
• Ready and accessible

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 Equipment and supplies

• Radiant heater
• Dry and sterile towels
• Blankets
• Clock
 Equipment for Newborn
Resuscitation
• Manual resuscitator (infant)
• Masks (2 sizes, term and premature)
• Suction equipment
• ET tubes (sizes 2.5, 3.0, 3.5)
• Laryngoscope and blades (sizes 0, 1)
Manual resuscitators
Masks
Suction device
ET Tube
Laryngoscope and blades
What else is there to prepare?
Delivery room

• Ensure that all surfaces the baby come in

contact with are clean (with some being
covered by sterile linen), warm, and dry

• Check that the necessary items for infection

prevention are available: water, soap, injection
safety box, bucket with a decontamination
solution, etc.

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Delivery room temperature and
lighting

• Make sure that the room is warm (around 25-

28 °C/ 77.0-82.4 °F) and free from drafts from
open windows and doors, with fans and air
conditioning being adjusted as needed

• If the temperature of the room is less than

optimal, turn the heater on, if one is available,
at the place where special care of the baby will
be carried out

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Delivery room temperature and
lighting

• Where a heater is available, place the

baby linen under/near it for warming
before delivery

• Make sure the room is well-lit

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Newborn baby corner

Make sure the table/surface where newborn

resuscitation and special care will be provided:
• Is clean, warm, dry, and without air drafts

• With clean mattress that can be

decontaminated or washed between babies
and covered with sterile cloth

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Newborn baby corner

Make sure the table/surface where newborn

resuscitation and special care will be provided:
• Is well-lit

• Has a heat source where possible

• Has all of the necessary equipment, supplies,

and medications for essential newborn care
and newborn resuscitation
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