Neonatal Resuscitation Algorithm Flashcard 5

C. Rationale: Epinephrine is the drug of choice during neonatal resuscitation. It is a sympathomimetic drug that increases heart rate, myocardial contractility, and systemic vasoconstriction. It activates the alpha- and beta-adrenergic systems.

C. Rationale: The following are indications for positive pressure ventilation: apnea, gasping, bradycardia < 100 bpm, and oxygen saturation below the target predicted preductal oxygen saturation despite free-flow oxygen supplementation or CPAP.

B. Rationale: The endotracheal route will require an epinephrine dose 10 times more than the calculated dose for IV or IO administration.

A. Rationale: In fetal circulation, gas exchange occurs in the placenta. Fetal blood bypasses the pulmonary circulation because the lungs are not yet functional, and this increases fetal heart efficiency because resistance from the contracted lung and pulmonary blood vessels is shunted via the ductus arteriosus.

D. Rationale: When a newborn does not respond to positive pressure ventilation, they likely have significantly low oxygen saturation, acidosis, and/or poor cardiac perfusion. These incapacitate cardiac function. Blood flow to the heart must be initiated by performing chest compressions.

B. Rationale: NRP guidelines recommend considering chest compressions after 30 seconds of effective positive pressure ventilation when the newly born continues to have a heart rate < 60 beats per minute.

D. Rationale: MR. SOPA stands for (1) mask adjustment, (2) reposition baby’s head, (3) suction airway, (4) open mouth, (5) pressure increase, (6) alternative airway. These are the troubleshooting procedures to improve the patient’s response to positive pressure ventilation.