DEFINITION:

Progressive hypoxia, acumulation of CO2 and

acidemia

CLASSIFICATION:
Without asphyxia (APGAR score 8-10)
Mild- moderate (APGAR score 4-7)
Severe (APGAR score 0-3)
Pre/intra natal : Placental insufficiency
Post natal: secondary of lung insufficiency
heat disease
Place under radiant heater
Dry thoroughly
remove wet line
Position
Suction mouth then nose
Tactile stimulation Evaluate respiration

None or gasping Spontaneous

< 100 x/m

PPV-O2, 100%, 15-30” Evaluate Heart rate

> 100 x/m

pink or peripheral Black
cyanosis

observe and monitor O2

Evaluation heart rate
 < 60 x/m 60 - 100 x/m > 100 x/m
- Continue HR not increasing HR increasing Watch for
ventilation - Continue Spontaneous
ventilation - continue respiration
- Check - Chest ventilation
compression compression Then discontinue
if HR < 80 x/m Ventilation

Initial medication if
HR < 80 x/m, after
30” PPV - 02 100%
&
Chest compression
• HR zero
or
• HR below 80/min after 30 seconds
PPV and chest compressions

Give May be repeated

epinephrine every 3-5 minutes
if required

HR Yes
above Discontinue
100
? medication

No
 Prolonged are that Evidence or suspicion
does not response to of acute blood loss with
other therapy signs of hypovolemia May be repeated
Give if signs of
Give
sodium bicarbonate volume expander hypovolemiapersist

Evidence
of continuing
depression ?

• Consider other caused, eg.

- Pneumothorax
- Diaphragmatic hernia
- Persistent pulmonary hypertension
• Consider stating dopamine
• Consultation
 Meconium in amniotic fluid

Intrapartum suctioning of
mouth, pharynx, and nose

Thin Thick

Infant Infant
active depressed

Suction
Observe trachea

Resuscitate PRN Resuscitate PRN

SALAH BETUL SALAH
 Correct Incorrect
pressure on sternum pressure on ribs