35 - Neonatal resuscitation and the management of immediate neonatalproblems

Summary

This chapter discusses the neonatal emergencies and resuscitation strategies in the newborns which differ from that of adults. Initial assessment of the newborn is based on the following parameters: colour, tone, breathing and heart rate. Pulse oximeter allows accurate assessment of heart rate and oxygen saturation within about 2 minutes of application. Emergency resuscitation drugs are very rarely required in the neonate. If a newborn cries at delivery, despite the presence of meconium, it will imply that the infant has an open airway and therefore no action is required. Newborn resuscitation follows a systematic stepwise approach with emphasis placed on temperature control, airway and breathing. The WHO guide recommends a simple, more feasible clinical criterion based on assessment of breathing alone: all babies who do not cry do not breathe at all, or who are gasping 30 seconds after birth should be resuscitated with bag-and-mask ventilation.