1.

When the head is delivered birth attendant immediately suction secretions

Wipe mucus from face and mouth and nose Aspirate/suction mouth and nose bulb syringe Keep head slightly lower than the body

Purposes: To provide patent airway. To remove secretions such as amniotic fluid. To increase respiratory ventilation. To increase tissue oxygenation. Equipments: Bulb syringe for newborn Basin Gauze Sterile water Sterile Gloves

Procedure
1. 2. 3. 4. 5.

6.

7.

Do meticulous hand washing. Wear Sterile Gloves Place infant in supine position. Squeeze the bulb until it is collapse. Place the tip in the nose or mouth and release the bulb. This will create suction and bring the mucus into the bulb. Remove the bulb syringe from the nose or mouth and squeeze it into a tissue to get the mucus out. After use, wash the bulb syringe in hot soapy water by squeezing the bulb several times. Squeeze in clear hot water to rinse.

3. Immediately dry infant under a radiant warmer or skin to skin contact with the mother

Keep neonates head covered

Infant temperature should be above 36.4C. Infants lose heat through evaporation, radiation, conduction and convection.

Convection
surrounding cool air - drafts

Radiation
transfer of heat to cooler objects not in direct contact with infant

Evaporation
wet surface exposed to air

Conduction
direct contact with cool objects

4. Obtain APGAR Scoring at 1 min and 5 min

Scoring 7-9 = free from immediate distress; normal 4-6 = moderately depressed; may require additional resuscitative measures 0-3 = severely depressed; necessitates immediate medical attention

 6.

Cord Care

A. Clamp umbilical cord approximately 2.5 cm (1 inch) from abdominal wall w/ cord clamp Examine clamp for closure, no oozing of blood from cord

B. Examine Cord for presence of 3 vessels and document

2

arteries and 1 vein

Alcohol 70% Povidone Iodine Dry dressing or Cotton Balls Plastic Cord Clamp (Commercially prepared) Forceps Cutting Scissors Sterile Gloves

Procedures: Do meticulous hand washing and wear sterile gloves. 2. Tie the cord inch from the base either with cord clamp, string or rubber, securely. 3. Cut the remaining cord 1 cm above the tie. 4. a. Clean the base of the umbilical cord inward going outward in one direction with Povidone Iodine then discard the cotton ball. b. Clean the cord with Povidone Iodine from the base going upward, one stroke in each side then discard the cotton. Then proceed to top side of the cord also with one gentle stroke then discards. 5. Clean the cord with alcohol 70% with the same stroke as above procedure with the povidone iodine 6.Pour out or wash the cord with pure 70% alcohol with out touching the cord anymore. 7. Keep the cord dry and exposed to air. 8. Document the procedure
1.

8. Instill eye prophylaxis

Given within 1 hour after birth Prevent ophthalmia neonatorum and Chlamydia trachomatis conjunctivitis Erythromycin ointment 0.5% Tetracycline ointment 1% Silver nitrate drops 1%

9.Administer a prophylactic vitamin K Prevent neonatal hemorrhage during first few days of life before infant is able to produce vit. K Recommended route of administration: intramuscular Dose: 1mg (of Konakion MM, 2mg/0.2ml) being given at birth. Preterm infants may receive 0.5mg. Equipments: 1 cc syringe with 25 gauge needle Cotton balls 70% alcohol Vitamin K ampoule Glove

Procedure
1.

Prepare medication for injection use 1 cc syringe with 25 gauge needle. For Pre-term give .05cc and for full term neonate prepares .1cc. 2. Put on Gloves 3. Position the newborn supine position, locate correct site,Vastus Lateralis (Outer middle portion of the thigh) use for giving IM injection to a newborn. 4. Cleanse area with cotton balls with 70% alcohol. 5. Stabilize the leg firmly while grasping the thigh between thumb and fingers. 6.Insert the needle at a 90 degrees angles 7. Aspirate the medication into the syringe if there is blood gently withdraw the injection and apply gently massage, if there is no blood upon aspirating inject Vitamin K and remove the needle and massage the site. 8. Throw needle in a sharp dispensing container. 9. Document in medication and nurses note.

Common Breastfeeding Positions

10. Bath once a baby's temperature has stabilized, the first bath can be given.

11. Footprints are often taken and recorded in the medical record.