logging in or signing up NRP-Introduction alassar Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 600 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: November 11, 2008 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: docspatil (35 month(s) ago) Dear sir, very great ppt. I am a pediatrician working with WHO-NPSP.Can you upload other NRP presentations or send me by e-mail - docspatil@gmail.com? Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Neonatal resuscitation : Neonatal resuscitation Slide 2: Primary cause of death: NNPD 4 million newborn deaths – Why?almost all are due to preventable conditions : 4 million newborn deaths – Why?almost all are due to preventable conditions Slide 4: Others: Hypothermia, RD, Jn, Pulm. Haemorrhage, Seizure etc. ICMR 2006 Neonatal resuscitation : Neonatal resuscitation Asphyxia accounts for 20-25% newborn deaths 10% neonates require some assistance at birth 1% neonates need extensive resuscitative measures The most important and effective action is to ventilate the baby’s lungs : The most important and effective action is to ventilate the baby’s lungs Neonatal resuscitation : Neonatal resuscitation Airway Breathing Circulation Neonatal resuscitation : Neonatal resuscitation Airway Breathing Circulation Before birth : Before birth Gas exchange in placenta Lung receives very little blood Alveoli are fluid filled Very little flow to lungs : Very little flow to lungs Alveoli are fluid filled : Alveoli are fluid filled Blood vessels are constricted Before birth : Before birth Pulm arterioles constricted Umbilical arteries feeding low pressure placenta circulation Low pressure in systemic circuit Very little pulmonary blood flow High pressure in pulmonary circuit After birth : After birth Fluid in the alveoli is absorbed Alveoli EXPAND GET FILLED WITH AIR (O2) 1. After birth : After birth Umbilical arteries and veins are clamped Sudden increase in systemic blood pressure 2. Pulmonary vessels dilate, causing increased blood flow to lungs : Pulmonary vessels dilate, causing increased blood flow to lungs 3. After birth : After birth Pulm arterioles dilate Umbilical arteries and veins are clamped High pressure in systemic circuit Dramatic increase in pulmonary blood flow Low pressure in pulmonary circuit Ductus arteriosus constricts : Ductus arteriosus constricts Increased oxygen in blood Increased pulmonary blood flow 4. Before : Before After What can go wrong : What can go wrong Inadequate breathing hence lung fluid not absorbed Meconium may block airway Blood loss may occur Persistence of constricted pulmonary vessels Myocardium may be depressed Organ systems may be affected by hypoxia/ischemia Consequences of interrupted transition : Consequences of interrupted transition Low muscle tone Resp depression (apnea / gasping) Tachypnea Bradycardia Hypotension Cyanosis Changes due to oxygen deprivation : Changes due to oxygen deprivation Some dictums : Some dictums If a baby does not breathe immediately after being stimulated >>> secondary apnea Assume every apneic baby is in secondary apnea Longer the duration of compromise, longer it takes for recovery Slide 23: The resuscitation flow diagram * Evaluation-Decision-Action cycle : Evaluation-Decision-Action cycle Evaluation Action Decision Evaluation: By 3 signs : Evaluation: By 3 signs Respiration Breathing / crying Apnea Heart rate <100 or not < 60 or not Color Central cyanosis Peripheral cyanosis / pink Slide 26: The resuscitation flow diagram * Evaluation Evaluation Evaluation Assessment Apgar score : Apgar score Apgar score is great, but not for guiding resuscitation : Apgar score is great, but not for guiding resuscitation For resuscitation, not all items are required Resuscitation initiated before 1 min when Apgar is assigned Classification different Requirements : Requirements Personnel At least one trained person for all deliveries Two persons, if high risk; or for advanced resuscitation Equipment Risk factors of asphyxia : Risk factors of asphyxia Only 50% resuscitation needs are identified prior to birth Premature babies : concerns : Premature babies : concerns May be surfactant deficient Immature brain, poor resp drive Weak muscles, not able to breathe More prone to hypothermia More likely to be infected Prone to intraventricular hemorrhage Small blood volume, prone to hypovolemia Immature tissues, prone to oxygen toxicity Slide 32: * Care after resuscitation Prevent, prevent, prevent : Prevent, prevent, prevent Infection : asepsis HIV : universal precautions You do not have the permission to view this presentation. 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NRP-Introduction alassar Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 600 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: November 11, 2008 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: docspatil (35 month(s) ago) Dear sir, very great ppt. I am a pediatrician working with WHO-NPSP.Can you upload other NRP presentations or send me by e-mail - docspatil@gmail.com? Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Neonatal resuscitation : Neonatal resuscitation Slide 2: Primary cause of death: NNPD 4 million newborn deaths – Why?almost all are due to preventable conditions : 4 million newborn deaths – Why?almost all are due to preventable conditions Slide 4: Others: Hypothermia, RD, Jn, Pulm. Haemorrhage, Seizure etc. ICMR 2006 Neonatal resuscitation : Neonatal resuscitation Asphyxia accounts for 20-25% newborn deaths 10% neonates require some assistance at birth 1% neonates need extensive resuscitative measures The most important and effective action is to ventilate the baby’s lungs : The most important and effective action is to ventilate the baby’s lungs Neonatal resuscitation : Neonatal resuscitation Airway Breathing Circulation Neonatal resuscitation : Neonatal resuscitation Airway Breathing Circulation Before birth : Before birth Gas exchange in placenta Lung receives very little blood Alveoli are fluid filled Very little flow to lungs : Very little flow to lungs Alveoli are fluid filled : Alveoli are fluid filled Blood vessels are constricted Before birth : Before birth Pulm arterioles constricted Umbilical arteries feeding low pressure placenta circulation Low pressure in systemic circuit Very little pulmonary blood flow High pressure in pulmonary circuit After birth : After birth Fluid in the alveoli is absorbed Alveoli EXPAND GET FILLED WITH AIR (O2) 1. After birth : After birth Umbilical arteries and veins are clamped Sudden increase in systemic blood pressure 2. Pulmonary vessels dilate, causing increased blood flow to lungs : Pulmonary vessels dilate, causing increased blood flow to lungs 3. After birth : After birth Pulm arterioles dilate Umbilical arteries and veins are clamped High pressure in systemic circuit Dramatic increase in pulmonary blood flow Low pressure in pulmonary circuit Ductus arteriosus constricts : Ductus arteriosus constricts Increased oxygen in blood Increased pulmonary blood flow 4. Before : Before After What can go wrong : What can go wrong Inadequate breathing hence lung fluid not absorbed Meconium may block airway Blood loss may occur Persistence of constricted pulmonary vessels Myocardium may be depressed Organ systems may be affected by hypoxia/ischemia Consequences of interrupted transition : Consequences of interrupted transition Low muscle tone Resp depression (apnea / gasping) Tachypnea Bradycardia Hypotension Cyanosis Changes due to oxygen deprivation : Changes due to oxygen deprivation Some dictums : Some dictums If a baby does not breathe immediately after being stimulated >>> secondary apnea Assume every apneic baby is in secondary apnea Longer the duration of compromise, longer it takes for recovery Slide 23: The resuscitation flow diagram * Evaluation-Decision-Action cycle : Evaluation-Decision-Action cycle Evaluation Action Decision Evaluation: By 3 signs : Evaluation: By 3 signs Respiration Breathing / crying Apnea Heart rate <100 or not < 60 or not Color Central cyanosis Peripheral cyanosis / pink Slide 26: The resuscitation flow diagram * Evaluation Evaluation Evaluation Assessment Apgar score : Apgar score Apgar score is great, but not for guiding resuscitation : Apgar score is great, but not for guiding resuscitation For resuscitation, not all items are required Resuscitation initiated before 1 min when Apgar is assigned Classification different Requirements : Requirements Personnel At least one trained person for all deliveries Two persons, if high risk; or for advanced resuscitation Equipment Risk factors of asphyxia : Risk factors of asphyxia Only 50% resuscitation needs are identified prior to birth Premature babies : concerns : Premature babies : concerns May be surfactant deficient Immature brain, poor resp drive Weak muscles, not able to breathe More prone to hypothermia More likely to be infected Prone to intraventricular hemorrhage Small blood volume, prone to hypovolemia Immature tissues, prone to oxygen toxicity Slide 32: * Care after resuscitation Prevent, prevent, prevent : Prevent, prevent, prevent Infection : asepsis HIV : universal precautions