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RESUSCITATION
Dr. Ashraf Fouda
Domiatte General Hospital
birth asphyxia is defined
simply as the failure to
initiate and sustain
breathing at birth
The common worry of health
professionals and parents is
the permanent brain damage
that birth asphyxia can
cause.
Management of baby
with birth asphyxia
1)Basic Resuscitation
2)Advanced Resuscitation
BASIC
RESUSCITATION
ABC’s of Resuscitation
A B C (A: Airway, B: Breathing, C: Circulation)
A - establish open airway
Position, suction
B - initiate breathing
Tactile stimulation
Oxygen
C - maintain circulation
Chest compressions
Medications
Basic Resuscitation
• Initial steps:
–Thermal management
–Positioning
–Suctioning
–Tactile stimulation
1.Anticipation.
2.Adequate preparation.
3.Timely recognition.
4.Quick and correct action
are critical for the success
of resuscitation
•Resuscitation must be
anticipated at every birth.
•Every birth attendant should
be prepared and able to
resuscitate
Good management of
pregnancy and
labour/delivery
complications
is the best means of
preventing birth asphyxia
For resuscitation:
1. A self-inflating Ambou bag (newborn size)
2. Two infant masks (for normal and small
newborn),
3. A suction device (mucus extractor),
4. A radiant heater (if available), warm towels, a
blanket and
5. A clock
are needed
The important steps in
resuscitation are:
1.Prevention of heat loss,
2.Opening the airway and
3.Positive pressure ventilation
that starts within the first minute
of life
The surface on which
the baby is placed
should always be
warm as well as flat,
firm and clean
This consists of :
drying, positioning the neonate under
radiant warmer to minimize heat loss
and suctioning of mouth and nose
(Tracheal suctioning if meconium
present).
This should only take approximately
20 seconds
Drying
provides sufficient
stimulation of breathing
in mildly depressed
newborns and no further
stimulation is appropriate
The second step
(within 20-30 seconds of birth)
is assessment of neonatal
respiration
Stop ventilation
•Do not separate the
mother and the newborn.
•Leave the newborn skin-
to-skin with the mother
•Encourage breast-feeding within
one hour of birth.
•The newborn that needs
resuscitation is at higher risk of
developing hypoglycaemia.
•Observe suckling .
Good suckling is a sign of
good recovery.
•Risk factors are poor
predictors of birth asphyxia.
•Up to half of newborns who
require resuscitation have no
identifiable risk factors
before birth.
•Taking an Apgar score is
not a prerequisite for
resuscitation.
•The need for resuscitation
must be recognized before the
end of the first minute of life
which is when the first Apgar
score is taken
Sign 0 1 2