Neonatal Resuscitation Algorithm Flashcard 2

D. Rationale: Stop chest compressions if the neonate’s heart rate is 60 bpm or above. Once chest compressions stop, provide positive pressure ventilation at a faster rate of 40–60 breaths per minute.

B. Rationale: If the heart rate increases to 60 bpm or higher, the team may stop chest compressions but continue PPV, titrating the oxygen concentration to the predicted preductal oxygen saturation.

B. Rationale: If the heart rate fails to reach 60 bpm, then a repeat dose every 3 to 5 minutes can be administered. Consider increasing the dosage from the previous one administered, being careful not to give a higher dose than what was calculated.

B. Rationale: Following the American Heart Association (AHA) neonatal resuscitation algorithm, after performing the initial steps and troubleshooting using the corrective steps in neonatal resuscitation, you must evaluate the newborn. If the patient still presents with bradycardia of < 60 bpm, the next step is to place an advanced airway such as an endotracheal tube or a laryngeal mask. If no one is available to place the advanced airway, chest compressions should be initiated.

B. Rationale: The heart rate is the most sensitive indicator of the need for additional intervention. When providing the initial steps in neonatal resuscitation, the clinician must carefully note two important clinical indicators, namely, respiration (apnea, gasping, labored breathing) and heart rate (< 100 bpm).

C. Rationale: Studies have shown that it takes a minute or more for the heart rate to increase after beginning chest compressions. NRP guidelines recommend waiting 60 seconds after starting coordinated chest compressions and ventilation before briefly pausing to reassess the heart rate. The team should avoid unnecessary interruptions in chest compressions. When chest compressions are halted, the coronary artery perfusion is decreased and requires some time to recover once chest compressions resume.

B. Rationale: When performing a pulse check or rhythm check, the healthcare provider can decide to cease compressions once the patient has a heartbeat of 60 beats per minute or more. Assisted ventilation must continue until the patient is stabilized.

C. Rationale: Chest compressions are indicated if, after 30 seconds of adequate positive pressure ventilation, the patient’s heart rate is < 60 beats per minute.

C. Rationale: Chest compressions are performed when the newly born does not respond to effective positive pressure ventilation. During this time, due to a lack of oxygen in the blood and significant acidosis, compounded with reduced cardiac perfusion, cardiac function has significantly deteriorated. Choice D is incorrect because chest compressions are recommended only if bradycardia (heart rate < 60 beats per minute) persists after the initial steps of resuscitation and effective positive pressure ventilation have failed.

A. Rationale: Resuscitating the newborn must concentrate entirely on providing adequate positive pressure ventilation. If this fails to increase the heart rate, it means that the cardiac function has deteriorated due to persistently low oxygen levels and acidosis, resulting from poor myocardial perfusion. Hence, the next step in neonatal resuscitation is the delivery of chest compressions so that the myocardium can be perfused with oxygen-rich blood.