Saturday, March 30, 2013

Newborn Class

I had the opportunity to take the Neonatal Resuscitation Program class last week. This is standardized class put together by the American Academy of Pediatrics and jointly sponsored by the American Heart Association. I was clued into it by a few of our providers that have taken it and thought it was time well spent. I figured that I should take that class and learn from it so I can speak the language of the others at Allina Health EMS who are taking care of newborns.

Key points:

There was a lot of information, but a few key things really stuck out and I would like to share them with those of you who have not taken that class.

  • Organization- like all other high stress events we have,  I encourage you to plan ahead. Work with your partner before you arrive and assign tasks. Who is going to place the oxygen?, who is going to ventilate and check the airway? who is going to check the cord and ensure it's clamped?. Being deliberate will help you a ton.
  •  Oxygen- against everything we want to do, we have got to stop reflexively putting oxygen on these newborns. Because of how their circulation transition from fetal to , it is normal for their oxygen saturations to start at 60% and rise to 90% over the next 5-10 minutes. The child is in no danger with those numbers for that period of time. In fact, they are suggesting that there may be problems if we artificially push the oxygen up to 100% immediately.
    • Important- the recommendation is to put the O2 sat monitor on their Right wrist.
Email me if you know why the right side is preferred!
  • Ventilation - it is all about ventilation. When challenged with a decision about intubating or placing an IV/IO, I wanted to place the IO to give epi for a slow heart rate. Then answer was always, put an ET tube in and see if that increases the heart rate. Wait on the IV.
    • So ventiltion is the priority.
Thanks all,

1 comment:

David Borrett, BA, NRP said...

If the right wrist probe is attached prior to attaching to the pulse oximeter, you will get a more accurate reading faster. Still can't figure out why that is.

14.O'Donnell CP, Kamlin CO, Davis PG, Morley CJ. Obtaining pulse oximetry data in neonates: a randomised crossover study of sensor application techniques. Arch Dis Child Fetal Neonatal Ed 2005; 90: F84–F85.