SAQ 454 – Paediatrics – initial neonatal assessment and resuscitation
Model Answer
Paediatrics – initial neonatal assessment and resuscitation.
a. Initial assessment
Feature
Details
Heart rate
Auscultate the heart or palpate the umbilical stump; greater than 100 is reassuring, 60-100 indicates distress, less than 60 is severe compromise/arrest.
Respiratory effort
Assess crying, breathing, gasping or apnoea.
Tone
Assess flexion, activity and limpness.
Colour/oxygenation
Assess central cyanosis and attach oximetry when possible.
Response to stimulation
Assess grimace/cry/movement with drying and stimulation.
b. First 2-3 minutes
Dry the infant.
Keep warm with towels/wrap/radiant warmer.
Stimulate.
Position the head/airway optimally and clear obvious obstruction only if needed.
Start assisted ventilation if breathing does not begin promptly; effective ventilation is the key intervention.
Prepare CPR if ventilation remains ineffective and the heart rate is around or below 60 after adequate ventilation.
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