NEONATAL RESUSCITATION PROGRAM
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)
,NEONATAL RESUSCITATION PROGRAM
**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
, NEONATAL RESUSCITATION PROGRAM
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
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)
,NEONATAL RESUSCITATION PROGRAM
**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
, NEONATAL RESUSCITATION PROGRAM
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
