scholarly journals Severe Birth Asphyxia without Sequelae: A Case Report

2019 ◽  
Vol 57 (218) ◽  
Author(s):  
Sujata Dahal ◽  
Roshan Lama ◽  
Nita Lohala ◽  
Prashant Simkhada ◽  
Meena Thapa ◽  
...  
Keyword(s):  
Heart Rate ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Perinatal Asphyxia ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Advanced Life Support ◽  
Neonatal Morbidity ◽  
Neurodevelopmental Delay ◽  
History Of

Perinatal asphyxia is one of the major causes of neonatal morbidity and mortality. It mainly causes neurodevelopmental delay leading to hypoxic-ischemic encephalopathy. We present here the case of a preterm male baby of 1670 grams born at 31+3 weeks of gestation delivered by 25-year-old primi mother through vaginal delivery with history of umbilical cord prolapse. At birth, the baby had no heart rate and cyanosed following which he was resuscitated according to the Neonatal Advanced Life Support 2015 guidelines protocol.  After 5 minutes of neonatal resuscitation, the baby’s heart rate reappeared, but was only upto 20 beats/min and resuscitation thus continued. But heart rate did not improve despite of using all form of resuscitation procedure including intubation and drugs. After 2 hours, baby cried spontaneously and later baby was managed in Neonatal Intensive Care Unit according to the neonatal unit protocol of the hospital.   

NRP Versus PALS for Infants Outside the Delivery Room: Not If, but When?

2021 ◽  
Vol 41 (6) ◽  
pp. 22-27
Author(s):  
Jaime Esbensen Doroba
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Delivery Room ◽  
Background Information ◽  
Neonatal Resuscitation Program ◽  
Support Guidelines

Background Both the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines can be used for infants requiring cardiopulmonary resuscitation outside the delivery room. Each set of guidelines has supporting algorithms for resuscitation; however, there are no current recommendations for transitioning older infants outside the delivery room. Objective To provide background information on the algorithms in the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines and to discuss the role that nurses and advanced practice nurses play in advancing scientific research on resuscitation. Content Covered Summaries of both sets of guidelines, differences in practices, and recommendations for practice changes will be discussed. Discussion Provider preference and unit practice determine which guidelines are used for infants outside the delivery room. Providers in pediatric intensive care units and pediatric cardiac intensive care units often use the Pediatric Advanced Life Support guidelines, whereas providers in neonatal intensive care units use the Neonatal Resuscitation Program guidelines for infants of the same age. The variation in resuscitation practices for infants outside the delivery room can negatively affect resuscitation outcomes.

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

scholarly journals Accuracy of real-time delivery room resuscitation documentation

2018 ◽  
Vol 105 (2) ◽  
pp. 222-224 ◽  
Author(s):  
Claire E Fishman ◽  
Danielle D Weinberg ◽  
Ashley Murray ◽  
Elizabeth E Foglia
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Real Time ◽  
Vital Sign ◽  
Gold Standard ◽  
Neonatal Intensive Care ◽  
Video Recording ◽  
Neonatal Resuscitation ◽  
Delivery Room ◽  
Level 3

ObjectiveTo assess the accuracy of real-time delivery room resuscitation documentation.DesignRetrospective observational study.SettingLevel 3 academic neonatal intensive care unit.ParticipantsFifty infants with video recording of neonatal resuscitation.Main outcome measuresVital sign assessments and interventions performed during resuscitation. The accuracy of written documentation was compared with video gold standard.ResultsTiming of initial heart rate assessment agreed with video in 44/50 (88%) records; the documented heart rate was correct in 34/44 (77%) of these. Heart rate and oxygen saturation were documented at 5 min of life in 90% of resuscitations. Of these, 100% of heart rate and 93% of oxygen saturation values were correctly recorded. Written records accurately reflected the mode(s) of respiratory support for 89%–100%, procedures for 91%–100% and medications for 100% of events.ConclusionReal-time documentation correctly reflects interventions performed during delivery room resuscitation but is less accurate for early vital sign assessments.

Standardized Vasoactive Medications: A Unified System for Every Patient, Everywhere

2005 ◽  
Vol 40 (11) ◽  
pp. 984-993 ◽  
Author(s):  
Kristin Niemi ◽  
Siobhan Geary ◽  
Mark Larrabee ◽  
Kevin R. Brown
Keyword(s):  
Patient Care ◽  
Life Support ◽  
Standard Dose ◽  
Infusion Pump ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Tertiary Hospital ◽  
Drug Preparation ◽  
Software Program ◽  
Vasoactive Medications

Providing medications used in emergency cardiovascular care (ECC) in an efficient and consistent manner is a cornerstone for achieving excellent patient care and safety. For neonatal, pediatric, and adult patients who move through different specialty areas in a tertiary hospital, it is essential to have a standardized protocol for these medications that can be followed regardless of location or practitioner. Our institution developed a protocol for intravenous push (IVP) and continuous infusion (CI) medications based on the Neonatal Resuscitation Program (NRP), Pediatric Advanced Life Support (PALS) and Advanced Cardiovascular Life Support (ACLS) guidelines. This protocol incorporates these guidelines into a single reference sheet (Emergency Drug Sheet) based on the patient's weight using a computer software program. The program provides the option for either pediatric (weight-based) or adult (weight-based and standard dose) dosing. The CI section uses a limited number of concentrations, which meets the JCAHO mandate. Commercially available products are used, when possible, in response to USP <797>. It also serves as the standard protocol for vasoactive medications in all patient care settings in conjunction with programmable infusion pump technology. The software program is easy to use; the Emergency Drug Sheet is easy to read; and the program is available everywhere in the hospital. The standard CI protocol used with the Emergency Drug Sheet reduces unclear orders, standardizes drug preparation, and decreases the time to medication delivery. It could serve as a model for community hospitals, as well as tertiary facilities.

Anaesthetic emergencies

2016 ◽  
Author(s):  
Andrew McIndoe
Keyword(s):  
Major Trauma ◽  
Status Asthmaticus ◽  
Basic Life Support ◽  
Life Support ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Gas Embolism ◽  
Gastric Aspiration ◽  
Drug Doses ◽  
Broad Complex

This chapter discusses anaesthetic emergencies. It begins with a description of adult basic life support and advanced life support. It goes on to describe the management of acute problems, including narrow and broad complex tachycardia, severe hypo- or hypertension, severe hypoxia, laryngospasm, air/gas embolism, gastric aspiration, status asthmaticus, pulmonary oedema, failed intubation, the cannot-intubate-cannot-ventilate scenario, malignant hyperthermia anaphylaxis, intra-arterial injection, and unsuccessful reversal of neuromuscular blockade. It concludes with the management of paediatric emergencies, including paediatric advanced life support, ventricular fibrillation or tachycardia, neonatal resuscitation, the collapsed septic child, paediatric major trauma, acute severe asthma, and anaphylaxis, as well as with a discussion of paediatric drug doses and equipment.

scholarly journals Etiological Factors& Clinical Courses of Birth Asphyxia in Rural and Urban Population of Kishanganj District.

2017 ◽  
Vol 16 (4) ◽  
pp. 554-556
Author(s):  
Dilip Kumar Mandal ◽  
Prasant Kumar ◽  
Uday Shankar Prasad ◽  
Shyamali Datta ◽  
Indranil Dawn ◽  
...  
Keyword(s):  
Urban Population ◽  
Medical Condition ◽  
Perinatal Asphyxia ◽  
Collaborative Study ◽  
Medical Science ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Related Complication ◽  
Maternal Risk ◽  
Rural And Urban

Problem statement : perinatal asphyxia, neonatal or birth asphyxia is a medical condition from deprivation of oxygen to a newborn infant long enough during the process to cause physical usually to the brain. And it is almost all neonatal deaths occur in our rural and urban area. Where the majority is delivered at homes with negligible antenatal care and poor prenatal services.Methods: In this collaborative study conducted prospective, descriptive study. As a case of 150 newborn babies and as a control 1190 newborn babies are fulfilled the selection criteria for prenatal and birth asphyxia .Results: Incidence of birth asphyxia in relation to ante partum and intrapartum factors. And shows that mother with complication like eclampsia, APH, PROM, cord accidents, failed progress of labor, obstructive labor & prolong 2nd stage of labor, etc were more likely to deliver asphyxiated baby, and analysis of maternal risk factors for birth asphyxia. Many pathological, biochemical & metabolic changes occurs as a result of birth asphyxia. And the data were analyzed by slandered statistical test, namely, Z test, Chi square test, and uniovariate and ultivariate logistic regression analysis of risk factor.Conclusion: In our study it was observed that, Pregnancy related complication in rural & urban population of Kishanganj district was mostly Eclampsia, pre-eclamptic toxaemia, Oligohydramnios, PROM(M24hr) etc. To prevent birth asphyxia trained personal and neonatal resuscitation equipment should be mandatory in all maternity home/hospital because prevention is the best and be only option to reduce the Pre natal & birth asphyxia.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.554-556

Basic and advanced life support in pediatrics: history of deployment in minas and update

2016 ◽  
Vol 26 ◽  
Author(s):  
Frederico Mitre Pessoa ◽  
Alexandre Rodrigues Ferreira ◽  
Maria do Carmo Barros de Melo ◽  
Monalisa Maria Gresta ◽  
Marcos Carvalho de Vasconcellos
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
History Of

scholarly journals Electrolyte abnormalities in asphyxiated newborns

2018 ◽  
Vol 5 (3) ◽  
pp. 1036
Author(s):  
Satheesh Kumar D. ◽  
Thenmozhi M. ◽  
Kumar .
Keyword(s):  
Serum Sodium ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Postnatal Period ◽  
P Value ◽  
Sodium Potassium ◽  
Neonatal Deaths ◽  
Electrolyte Abnormalities

Background: Perinatal asphyxia is the most common cause of neonatal morbidity and mortality in worldwide. It accounts for 23% of all neonatal deaths. Electrolyte abnormalities are more common in the immediate post asphyxiated period and influence neonatal the outcome effectively. Aim of this study was to measure the serum sodium, potassium and calcium levels in immediate postnatal period of asphyxiated newborns and assess the correlation with different degree of birth asphyxia.Methods: The serum sodium, potassium and calcium levels were measured in asphyxiated newborns in the early post-natal period. Both intramural and extramural newborns were included irrespective of their mode of delivery but according to the Apgar score. The measured electrolyte values were compared with the different severity of asphyxia. Results: Out of 100 newborns 53 had hyponatremia, 10 had hyperkalemia and 3 had hypocalcemia. The serum sodium and potassium levels showed significant P value (<0.00) with the different degree of both asphyxia but calcium levels were not significant (p valve = 0.06). There was a negative linear correlation with sodium and calcium levels and positive correlation with the serum potassium levels.Conclusions: Hyponatremia was significant in all stages of birth asphyxia, hyperkalemia was significant with increased severity of birth asphyxia and hypocalcemia was only weakly significant even in severe birth asphyxia.

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

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