NRP flashcards for the 9th Edition

What is the expected gestational age? Is the amniotic fluid clear? Are there any additional risk factors? What is the umbilical cord management plan?

Is the baby term? Is the muscle tone good? Is the baby breathing or crying?

If any answer is no at the time of cord clamping, bring the baby to the radiant warmer. If all three are yes, the baby can stay skin to skin with the parent.

When the baby is not breathing, is gasping, or has a heart rate below 100 bpm by 1 minute after birth. Start ventilation within 1 minute of birth.

For most babies, at least 60 seconds. Cord management should not delay ventilation for a baby who is still apneic or has a heart rate below 100 bpm by 60 seconds after birth.

No. Routine laryngoscopy, with or without intubation for tracheal suction, is not suggested. Intubation and tracheal suction are recommended if the baby needs assisted ventilation and there is concern for airway obstruction.

Ventilating the baby's lungs. Respiratory failure is the most common reason a newborn needs resuscitation.

Rate: 30 to 60 breaths per minute. Peak inflation pressure: 25 cm H₂O (25 to 30 for term babies and preterm babies of 32 weeks or more, 20 to 25 for preterm babies under 32 weeks). PEEP: 5 cm H₂O, if used.

A rising heart rate.

MR SOPA: Mask adjustment, Reposition the head and neck, Suction the mouth and nose, Open the mouth, Pressure increase, Alternative airway.

Start them if the heart rate isn't rising within 15 to 30 seconds of ventilation and you don't see chest movement.

35 weeks or more: 21%. 32 to 34 weeks: 21% to 30%. Under 32 weeks: 30% or higher may be considered.

Then adjust to the minute-specific SpO₂ targets using a pre-ductal pulse oximeter.

When the heart rate stays below 60 bpm despite at least 30 seconds of ventilation that inflates the lungs (the chest moves).

Ventilation should usually be through an endotracheal tube by then. A correctly placed laryngeal mask is reasonable if intubation isn't successful or feasible.

3 compressions to 1 breath: 90 compressions and 30 breaths per minute. Use the rhythm "One-and-Two-and-Three-and-Breathe." Ventilate with 100% oxygen until the heart rate is at least 60 bpm and the oximeter has a reliable signal.

Thumb tips in the midline of the sternum, just below an imaginary line between the nipples, with both hands encircling the chest. Press about one third of the front-to-back diameter of the chest.

When the heart rate is still below 60 bpm after at least 30 seconds of ventilation that inflates the lungs and another 60 seconds of chest compressions coordinated with ventilation using 100% oxygen.

Only the dilute 0.1 mg/mL (1 mg/10 mL) concentration.

IV or IO: 0.02 mg/kg (acceptable range 0.01 to 0.03), repeated every 3 to 5 minutes. Endotracheal: 0.1 mg/kg (0.05 to 0.1), only while vascular access is being established.

When the baby isn't responding to resuscitation and there are signs of shock or a history of acute blood loss. The dose is 10 mL/kg.

No. 1 for a term baby and No. 0 for a preterm baby. No. 00 is optional for an extremely preterm baby.

Exhaled carbon dioxide and a rapidly rising heart rate are the primary methods. Also listen for equal breath sounds, and confirm with a chest radiograph if the tube will stay in.

The causes to check when a baby suddenly worsens after intubation: Displaced tube, Obstructed tube, Pneumothorax, Equipment failure.

A room at 23 to 25 °C (74 to 77 °F). For a baby under 32 weeks, also prepare a polyethylene plastic bag or wrap and a thermal mattress, and have a ventilation device that can give PEEP and CPAP.