Qn 1.

Explain New-born life support (NLS) elements (5mks)

1. Enabling placental transfusion (when able to do so) by delaying the clamping of the
umbilical cord.
2. Drying and covering the new-born infant, and where necessary taking additional
steps, to maintain a normal body temperature (i.e. between 36.5°C and 37.5°C).
3. Assessing the infant’s condition and the need for any intervention
4. Maintaining an open airway.
5. If the infant is not breathing, aerating the lungs with inflation breaths.
6. Continue ventilating apnoeic infants until respiration is established.
7. If the heart remains less than 60 min after 5 effective inflation breaths and 30 seconds
of effective ventilation, start chest compressions.
8. Administration of drugs (rarely).

Qn 2. With examples differentiate between new born support of transition and

resuscitation. (5mks)

New born support of transition-in prematures most of the time CPAP needed due to
immature lungs.

Resuscitation is full blown support in either premies or term baby who has suffered
intra uterine placental compromise. Includes airway, breathing cardiac support with
fluids or drugs as needed.

Qn 3. A PG with obstructed labour- contracted pelvis, foetal distress noted,

taken for C/S, New-born not doing well, RR 12/min, HR 92/min. How would you
manage the NLS? (5mks)

Should mention
 ANC risk factors identified.
 Equipment preps-neonatal resuscitation station
 Team composition.
 At CS no need of cord clamping in emergency but quick delivery and
warming.
 NLS. In this case quick assessment with attached pulse ox, ECG/stethoscope
note reduced HR-92, together with RR 12 (agonal gasps) and others like tone,
colour all in 10sec, hence need for 5 inflation breathes with ventilation for
30secs while assessing for increasing HR.
 Need for chest compressions if with respiratory support HR still goes below
60. In next 30sec at Ratio of 3:1 encircling technique.
 Need for IV drugs (adrenaline, NAHCO3, dextrose) and fluid bolus if HR still
low even after compression.
 All events should have been gone through by first 1 min of life.
 Need for post resuscitation care in NICU.