ASPHYXIA

Rinawati Rohsiswatmo Divisi Neonatologi Departemen Ilmu Kesehatan Anak FKUI - RSCM

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Definision
 Asphyxia

is defined as the failure to breathe well within one minute after delivery.
is defined as too little oxygen in the cells of the body.
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 Hipoxia

Apgar Score  Is a method of assessing an infant’s clinical condition after delivery.The APGAR SCORE is based on 5 vital signs. 3 .

pale) Pulse* ------< 100 x/m > 100 x/m Grimace ------Grimace Cough of Sneeze Activity Limp Some flexion Active of extremities motion Respiratory* ------Irregular Good criying 4 .Apgar/… SIGN Appearance* S 0 C O R 1 E 2 Central Cyanosis Peripheral Cyanosis All Pink (blue.

ALL INFANTS WITH 1 a (ONE) MINUTE APGAR SCORE < 7 REQUIRE RESUSCITATION 5 .

All Infants/…  What causes a low APGAR SCORE * Fetal distress due to hypoxia before delivery * Maternal anesthesis or recent analgesia * Preterm infant * Difficult suctioning of the pharynx after delivery * Severe respiratory distress 6 .

 Difficult of traumatic delivery.  General anaesthesia or recent analgesia .  Delivery < 37 weeks of gestation.  Abn.Which baby will need resuscitation at birth?  Sign of fetal distress during labour. 7 .  All infant can have asphyxia at birth without warning signs during labour.presentation of the fetus.

8 .Equipments for infant resuscitation  Suction Apparatus  It is not necesssary to routinely suction the mouth and nose of infants after delivery.  Meconium stained infants must be suctioned before they start breathing.  A stomach washout is only needed if the infant is meconium stained.

Bicarbonate. adrenaline  Wall clock 9 .Equipment/… O xygen  Resuscitator  Endotracheal tubes  Laryngoscope  Naloxone ---------- Sod.

How do you resuscitate an infant A B C D Airway Breathing Circulation Drugs 10 .

ALUR RESUSITASI 11 .

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What organs are commonly damaged by Hypoxia  The Brain  The Kidneys  The Heart  The Gut  The Lungs Haematuria in the newborn infant is a useful clinical marker of prenatal hypoxia. 15 .

Prevention of infections  Exclusive breastfeeding  Keep cord dry  Hand washing by care givers  Hygiene of baby  No unneccessary interventions 16 .

SIX STEPS OF HAND 17 .

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 Mortality rate twice in hypothermic babies.Hypothermia  Significant problem in neonates at birth and even at 24 hrs of age and beyond. Contributes to significant morbidity & mortality. 23 .

 Reduced amount of brown fat ( LBW infant).  Decreased thermal insulation due to lack of subcutaneous fat.Why are newborns prone to develop hypothermia ?  Larger surface are per unit body weight. 24 .

25 .Temperature recording  Axillary temperature recording for 3 minutes is recommended for routine monitoring.  Record rectal temperature in a sick hypothermic neonate.  Don’t record rectal temperature in all babies as a standard protocol.

 Don’t bathe immediately after birth. 26 .Prevention of hypothermia at birth  Delivery in warm room.  Warp baby in pre-warmed cloth. cover head.  Dry baby immediately with warm clean towel.  Keep next to mother.

decreased perfusion CNS depression . cool extremities . poor feeding.Signs and symptoms of hypothermia   Peripheral vasoconstriction . bradycardia.lethargy.acrocyanosis. apnea. 27 .

weight loss. hypoxia.distress. acidosis. poor weight gain.  Increased pulmonary artery pressure .Signs and/…  Increased metabolism . 28 .hypoglycemia. tachypnea.  Chronic signs .

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