NEONATAL RESUSCITATION PROGRAM- NRP
5 INITIAL STEPS OF NEWBORN CARE
1. Provide warmth
2. Position head and neck to open airway
3. Clear secretions if necessary
4. Dry baby
5. Stimulate
**Establishing Effective Ventilation of the baby’s
lungs is the MOST IMPORTANT and effective action
during resuscitation
4 QUESTIONS TO ASK BEFORE EVERY BIRTH
1. What is expected gestational age
2. Is the amniotic fluid clear
3. How many babies are expected
4. Are there any additional risk factors
RAPID EVALUATION FOR ALL NEWBORNS IS
REQUIRED—ASK IF THE BABY IS:
1. Term?
2. Tone? (Healthy babies should be active and flex
extremities)
3. Breathing/Crying? (Gasping is a sign of severely
impaired gas exchange)
,**If the answer is NO to any of these, the newborn
should be brought to the radiant warmer for the initial
steps of newborn care
Fetal lungs do not participate in gas exchange but are
expanded—alveoli is filled with fluid, NOT air but are
still expanded—pulmonary vessels are tightly
constricted
Oxygenated fetal blood leaves placenta through
umbilical vein—there is 1 vein, 2 arteries in the
umbilicus
Opening in atrium is a Patent Foramen Ovale-most
blood bypasses lungs through the foramen OR flows
from pulmonary artery into aorta through ductus
arteriosis
Right to left shunting is when blood follows a
circulation path and bypasses the lungs
Oligohydramnios- deficiency of amniotic fluid
Polyhydramnios- excessive amniotic fluid
Fetal hydrops- serious condition defined as abnormal
accumulation of fluid in 2 or more compartments
including ascites, pleural effusion, pericardial effusion,
and skin edema
, Chorioamnionitis- inflammation of the fetal membranes
(amnion and chorion) due to a bacterial infection-
Bacteria ascends from the vagina into the uterus usually
caused by prolonged labor
Newborns usually require resuscitation because of a
problem with respiration leading to inadequate gas
exchange
-Fetal respiration is performed by the placenta
-When placental respirations fail, the fetus receives an
insufficient supply of O2 to support cellular function
and CO2 cannot be removed
Babies temp should be maintained between 36.5-37.5C
(97.7-99.5F) during resuscitation
Place baby supine with head and neck in the sniffing
position (do not hyperextend or flex-chin to chest)
Clear secretions if baby is not breathing, gasping or has
poor tone or meconium stained fluid
Suction mouth THEN nose *Remember M before N
-can use bulb syringe
-if using suction, catheter, set to 80-100 mmHg
Dry baby if wet-discard wet towels
If baby is less than 32 weeks, wrap in polyethylene
plastic
5 INITIAL STEPS OF NEWBORN CARE
1. Provide warmth
2. Position head and neck to open airway
3. Clear secretions if necessary
4. Dry baby
5. Stimulate
**Establishing Effective Ventilation of the baby’s
lungs is the MOST IMPORTANT and effective action
during resuscitation
4 QUESTIONS TO ASK BEFORE EVERY BIRTH
1. What is expected gestational age
2. Is the amniotic fluid clear
3. How many babies are expected
4. Are there any additional risk factors
RAPID EVALUATION FOR ALL NEWBORNS IS
REQUIRED—ASK IF THE BABY IS:
1. Term?
2. Tone? (Healthy babies should be active and flex
extremities)
3. Breathing/Crying? (Gasping is a sign of severely
impaired gas exchange)
,**If the answer is NO to any of these, the newborn
should be brought to the radiant warmer for the initial
steps of newborn care
Fetal lungs do not participate in gas exchange but are
expanded—alveoli is filled with fluid, NOT air but are
still expanded—pulmonary vessels are tightly
constricted
Oxygenated fetal blood leaves placenta through
umbilical vein—there is 1 vein, 2 arteries in the
umbilicus
Opening in atrium is a Patent Foramen Ovale-most
blood bypasses lungs through the foramen OR flows
from pulmonary artery into aorta through ductus
arteriosis
Right to left shunting is when blood follows a
circulation path and bypasses the lungs
Oligohydramnios- deficiency of amniotic fluid
Polyhydramnios- excessive amniotic fluid
Fetal hydrops- serious condition defined as abnormal
accumulation of fluid in 2 or more compartments
including ascites, pleural effusion, pericardial effusion,
and skin edema
, Chorioamnionitis- inflammation of the fetal membranes
(amnion and chorion) due to a bacterial infection-
Bacteria ascends from the vagina into the uterus usually
caused by prolonged labor
Newborns usually require resuscitation because of a
problem with respiration leading to inadequate gas
exchange
-Fetal respiration is performed by the placenta
-When placental respirations fail, the fetus receives an
insufficient supply of O2 to support cellular function
and CO2 cannot be removed
Babies temp should be maintained between 36.5-37.5C
(97.7-99.5F) during resuscitation
Place baby supine with head and neck in the sniffing
position (do not hyperextend or flex-chin to chest)
Clear secretions if baby is not breathing, gasping or has
poor tone or meconium stained fluid
Suction mouth THEN nose *Remember M before N
-can use bulb syringe
-if using suction, catheter, set to 80-100 mmHg
Dry baby if wet-discard wet towels
If baby is less than 32 weeks, wrap in polyethylene
plastic
