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Neonatal resuscitation, also known as newborn resuscitation, is an emergency procedure focused on supporting approximately 10% of newborn children who do not readily begin breathing, putting them at risk of irreversible organ injury and death. [1] Many of the infants who require this support to start breathing well on their own after assistance.
The program is intended for healthcare providers who perform resuscitation in the delivery room or newborn nursery. [4] Providers who take the Neonatal Resuscitation Program are diverse in their scope of practice. The course outline is flexible to allow providers to complete specific modules directly related to their practice. [5]
Some countries offer postgraduate degrees in neonatal nursing, such as the Master of Science in Nursing (MSN) and various doctorates. A nurse practitioner may be required to hold a postgraduate degree. [6] The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes. [7]
The Apgar score is a quick way for health professionals to evaluate the health of all newborns at 1 and 5 minutes after birth and in response to resuscitation. [1] It was originally developed in 1952 by an anesthesiologist at Columbia University, Virginia Apgar, to address the need for a standardized way to evaluate infants shortly after birth.
An infant with severe perinatal asphyxia usually has poor color , perfusion, responsiveness, muscle tone, and respiratory effort, as reflected in a low 5 minute Apgar score. Extreme degrees of asphyxia can cause cardiac arrest and death. If resuscitation is successful, the infant is usually transferred to a neonatal intensive care unit.
The PALS guidelines comment on this issue: "There are no data regarding the safety or efficacy of adjusting the doses of resuscitation medications in obese patients. Therefore, regardless of the patient’s habitus, use the actual body weight for calculating initial resuscitation drug doses or use a body length tape with pre-calculated doses." [5]
Lazarus phenomenon is the rare spontaneous return of circulation after cardiopulmonary resuscitation attempts have stopped in someone with cardiac arrest. This phenomenon most frequently occurs within 10 minutes of cessation of resuscitation, thus passive monitoring is recommended for 10 minutes following CPR cessation. [10]
When the primary survey is completed, resuscitation efforts are well established, and the vital signs are normalizing, the secondary survey can begin. The secondary survey is a head-to-toe evaluation of the trauma patient, including a complete history and physical examination, including the reassessment of all vital signs.
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