NRP 8th Edition Questions and
Answers (Graded A).
What is the single most important and effective step in neonatal resuscitation? - -
Ventilation of the newborn's lungs
-Abnormal Transition Findings -
--Irregular Breathing, absent breathing, or rapid breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
-NRP algorithm- First Step –
-Antenatal Counselling
Team Debriefing
Equipment Check
-After the birth of the baby, what do you ask? - -
1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
-FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do? -
-Warm
Dry
Stimulate
Position airway
Suction if needed
-Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis –
-Position airway, suction if needed
Pulse oximeter
Oxygen if needed
Consider CPAP
-Apnea or gasping? HR <100bpm= YES –
-PPV
Pulse Oximeter
Consider Cardiac Monitor
-HR STILL less than 100bpm= YES - -Ensure adequate ventilation
, Consider ETT or laryngeal mask
Cardiac Monitor
-HR <60 bpm? - -ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
-HR STILL <60 bpm? - -IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
-Rapid Evaluation - -Determine if the newborn can remain with the mother or should
be moved to the radiant warmer for further evaluation
-REVIEW: Three questions you ask during rapid evaluation? - -1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
-Airway - -Perform the initial steps to establish an open Airway and support
spontaneous respiration
-Breathing - -PPV is provided to assist Breathing for babies with apnea or bradycardia
-Circulation - -If severe bradycardia persists despite assisted ventilation, Circulation is
supported by performing chest compressions coordinated with PPV
-Drug - -If severe bradycardia persists despite assisted ventilation and coordinated
chest compressions, the Drug Epinephrine is administered as coordinated PPV and
chest compressions continue
-What are the 4 pre-birth questions to ask the provider before every delivery? - -1.
Expected Gestational Age
2. Is the amniotic fluid clear?
3. Are there any additional Risk Factors?
4. What is our umbilical cord management plan?
-Equipment Check- Warm - --Preheated radiant warmer
-Towels/Blankets
-Temp Sensor/sensor cover
-Hat
-Plastic Wrap (<32 weeks)
-Thermal Mattress (<32 weeks)
-Equipment Check- Clear the airway - --Bulb Syringe
Answers (Graded A).
What is the single most important and effective step in neonatal resuscitation? - -
Ventilation of the newborn's lungs
-Abnormal Transition Findings -
--Irregular Breathing, absent breathing, or rapid breathing
-Slow or fast heart rate
-Decreased Muscle Tone
-Pale Skin or Blue Skin
-Low oxygen saturation
-Low blood pressure
-NRP algorithm- First Step –
-Antenatal Counselling
Team Debriefing
Equipment Check
-After the birth of the baby, what do you ask? - -
1. Term Gestation?
2. Good Tone?
3. Breathing or crying?
-FIVE INITIAL STEPS:
If you answer NO to any of the three questions (term, tone, breathing) what do you do? -
-Warm
Dry
Stimulate
Position airway
Suction if needed
-Apnea or gasping? HR <100bpm= NO with laboured breathing/cyanosis –
-Position airway, suction if needed
Pulse oximeter
Oxygen if needed
Consider CPAP
-Apnea or gasping? HR <100bpm= YES –
-PPV
Pulse Oximeter
Consider Cardiac Monitor
-HR STILL less than 100bpm= YES - -Ensure adequate ventilation
, Consider ETT or laryngeal mask
Cardiac Monitor
-HR <60 bpm? - -ETT or laryngeal mask
Chest compressions
Coordinate PPV-100% oxygen
UVC
-HR STILL <60 bpm? - -IV Epinephrine every 3-5 minutes
If still less than 60, consider hypovolemia or pneumothorax
-Rapid Evaluation - -Determine if the newborn can remain with the mother or should
be moved to the radiant warmer for further evaluation
-REVIEW: Three questions you ask during rapid evaluation? - -1. Term?
2. Good Muscle Tone?
3. Breathing/crying?
If the answer is NO to any of these, baby should be brought to radiant warmer.
-Airway - -Perform the initial steps to establish an open Airway and support
spontaneous respiration
-Breathing - -PPV is provided to assist Breathing for babies with apnea or bradycardia
-Circulation - -If severe bradycardia persists despite assisted ventilation, Circulation is
supported by performing chest compressions coordinated with PPV
-Drug - -If severe bradycardia persists despite assisted ventilation and coordinated
chest compressions, the Drug Epinephrine is administered as coordinated PPV and
chest compressions continue
-What are the 4 pre-birth questions to ask the provider before every delivery? - -1.
Expected Gestational Age
2. Is the amniotic fluid clear?
3. Are there any additional Risk Factors?
4. What is our umbilical cord management plan?
-Equipment Check- Warm - --Preheated radiant warmer
-Towels/Blankets
-Temp Sensor/sensor cover
-Hat
-Plastic Wrap (<32 weeks)
-Thermal Mattress (<32 weeks)
-Equipment Check- Clear the airway - --Bulb Syringe
