NEONATAL

RESUSCITATION
Rachel Musoke
University of Nairobi
KNH/UON SYMPOSIUM 10TH Jan
2013

Poor intrapartum fetal

oxygenation
Also referred as asphyxia
Common cause of death & long term
disability (mental & neurological)
Estimated to contribute to 9% of all
< 5 mortality (MDG 4)
Burden of disease assessment 42
million disability-adjusted life years
(DALYs)

Contributing factors
The delays
Delay in recognition of the problem
in the mother
Delay in transportation to a medical
facility
Delay in providing appropriate care
at the health facility

Solutions to reduce deaths

& disability
Primary prevention maternal care
(early recognition & management)
Secondary prevention
appropriate neonatal
resuscitation
Tertiary prevention recognition &
management of acute complications

The Global Need for neonatal

Resuscitation, FIGO, Wall et al

Which babies need

resuscitation?
Assess:
Gestation term or preterm?
Breathing or Crying?
Good tone?
If NO then act quickly

The first golden

minute

The ABC of resuscitation

Airway (Position and clear)
Breathing (stimulate to breathe)
Circulation (Majority of babies have
normal hearts)

Warmth

Breathing

Ventilation of babys lungs is the

most important and effective
action in neonatal resuscitation

Room air vs.O2 for

Resuscitation

Term Infants

Pre-Term Infants
(< 32 weeks)

Room air or oxygen?

Term infants:
Mortality lower with room air vs 100% O2
Shorter recovery

Preterm
Balance the needs for oxygen vs
possible toxicity

Oxygen saturations at
birth
1 minute

60-65%

2 minutes

65-70%

3 minutes

70-75%

4 minutes

75-80%

5 minutes

80-85%

10 minutes

85-95%

Meconium stained liquor

Clear mouth & nose before drying &
stimulation to avoid aspiration
Suctioning of the trachea reserved
for nonvigorous babies

Equipments
Warmth towels & heater
Airway suction catheters
Ventilate bag (500ml). & masks
(sizes)
Source of oxygen (& blender)
Auscultate stethoscope
Pulse oximeter (if possible)
Intubation equipment

Key behavior skills

Know your environment

Anticipate & plan
Call for help & work as a team
The person present must initiate
resuscitation
Communicate effectively
Use all available resources

SUMMARY

Effective Resuscitation

Airway & Breathing

Circulation
Drugs

Summary
Everybody who conducts a delivery
must be able to resuscitate
We should be prepared at all times
Lets give our newborn a good start