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EM Clerkship

Neonatal Resuscitation (Deep Dive R22)

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Health & Fitness, Science, Education, Medicine, Life Sciences

4.9816 Ratings

🗓️ 15 June 2021

⏱️ 10 minutes

🧾️ Download transcript

Summary


Neonatal Resuscitation



*THIS IS A BASIC FRAMEWORK AND IS NOT COMPREHENSIVE*



* EVALUATE* Is the newborn crying/breathing spontaneously? Does the newborn have good tone? Is the newborn a term infant?* If YES, hand baby to mom for direct skin-to-skin.* If NO, proceed to step 2.* INTERVENE* STIMULATE – dry vigorously* WARM – place cap on head, place in warmer* OPEN AIRWAY – sniffing position, oral/nasal airway, suction if necessary* ASSESS HR (manually)* If HR>100, continue above interventions and move to PPV if not improving/if pulse ox low* If HR 60-100, attach to telemetry and pulse oximetry and begin PPV with room air at a rate of 60.* If HR<60, this is a CODE situation. Chest compressions and ventilations in a 3:1 ratio (“one and two and three and breath”), use PPV with 100% FiO2. Obtain access via UC or IO line, and intubate. Use epinephrine / fluid bolus if no improvement in 60 seconds. Check glucose, supplement with dextrose if necessary.



PEARL: At one minute of life, we expect an SpO2 of 60%.  Every minute afterwards, we expect the SpO2 to increase by 5%, so by 5 minutes of life it should be around 80%.  



Neonatal Resuscitation – Emergency Medicine Cases

Transcript

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0:00.0

Hello, students. Thank you for joining me today on this month's deep dive episode on the EM

0:07.0

Clerkship podcast. If you haven't already, I would recommend listening to this month's episode of the game before proceeding for two reasons.

0:16.3

One, it'll give you some context on the topic ahead. And two, it was a total blood bath, so if you

0:23.0

enjoy seeing me squirm on air, it's a pretty good one. Maybe not as bad as the lateral

0:27.5

canthotomy episode, but still pretty bad. Before we proceed, just a quick word from our sponsors,

0:33.1

Pearson Rabbit's insurance. Disability insurance is one of those things that many people do not realize

0:38.0

the importance of until it's too late. It is especially important for specialized physicians to

0:43.1

obtain own occupation disability insurance. This distinction is very important because it means

0:48.9

that you will receive your full disability benefits as long as you are unable to work in your

0:53.6

current specialty, regardless of your ability to work in your current specialty, regardless

0:55.3

of your ability to work in other specialties or other roles. For example, let's say you're an

1:00.9

otherwise healthy ER doc, who tragically loses an arm in an accident until you are no longer

1:06.6

able to perform emergency procedures. You take on a new job where you spend your time teaching

1:11.3

medical students as well as seeing patients in clinic once a week as a GP. With own occupation

1:16.7

disability insurance, you would still receive your full disability payout regardless of the money

1:22.3

that you are making as an educator slash GP. Sarah Pearson of Pearson Rabbit's insurance has firsthand experience going through this

1:30.1

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policy you want. She is a physician and she speaks our language. Check out Pearson Rabbits at

1:41.2

www.com. That's P-E-A-R-S-O-.personravits.com.

1:45.0

That's P-E-A-R-S-O-N-R-A-V-I-T-Z.com.

1:53.2

Now back to the episode.

1:55.0

Today, we're going to be talking about neonatal resuscitation.

...

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