L3 Newborn Life Support V3 November 2022.pdf

Newborn Life Support CSR 2022 Contents Overview of fetal and newborn physiology Preparing for a newborn baby Thermoregulation Cord care Assessment Newborn Life Support Algorithm Special considerations London Ambulance Service NHS Trust 2 Newborn Life Support Most babies...

Newborn Life Support CSR 2022 Contents Overview of fetal and newborn physiology Preparing for a newborn baby Thermoregulation Cord care Assessment Newborn Life Support Algorithm Special considerations London Ambulance Service NHS Trust 2 Newborn Life Support Most babies cope with birth well and are born in good condition The need for resuscitation or support for transition at birth is often not predictable Newborn Life Support Algorithm is for use at birth up until 12 hours old London Ambulance Service NHS Trust 3  Fetal circulation Transition at birth Thermoregulation London Ambulance Service NHS Trust 4 Transfer from Fetal Circulation At birth the following need to happen: 1. Fetal circulation needs to quickly shut down 2. The cord is made redundant (after a few minutes) 3. The pulmonary circulation needs to open Mostly this happens spontaneously London Ambulance Service NHS Trust 5  Fetal circulation Transition at birth Thermoregulation London Ambulance Service NHS Trust 6 1 minute old London Ambulance Service NHS Trust 7 What is the main cause of collapse in adults? …. and what is it in babies? London Ambulance Service NHS Trust 8  Adults have cardiac arrests Babies have respiratory arrests London Ambulance Service NHS Trust 9 At birth, babies are: Small Wet Attached to the placenta Lungs are full of fluid London Ambulance Service NHS Trust 10  What stimulates a baby to take their first breath? London Ambulance Service NHS Trust 11 The first breath may be stimulated by: Hypoxia (physiological) Temperature change Physical stimulation London Ambulance Service NHS Trust 12  Spontaneous aeration of the lungs 0.0 seconds 0.3 seconds 0.6 seconds Lungs full of air Lungs full of fluid London Ambulance Service NHS Trust 13  Fetal circulation Transition at birth Thermoregulation London Ambulance Service NHS Trust 14  Why is thermoregulation important? London Ambulance Service NHS Trust 15 Thermoregulation Babies are very vulnerable to rapidly losing heat- why? Optimising thermoregulation should not be seen as delaying care – it is ESSENTIAL London Ambulance Service NHS Trust 16  For every 1 degree below 36.5 degrees there is risk increase of 28% of infant mortality London Ambulance Service NHS Trust 17 Use everything you have got Environment: exclude drafts, shut windows, turn off fans, turn up heating Actions at birth: dry thoroughly, change the wet towels to dry ones, apply a hat Wrapping the baby: in dry towels and blizzard blanket. Use transwarmer if available (APP) London Ambulance Service NHS Trust 18 Initial Assessment (First minute of life) COLOUR- Pink centrally (well-perfused)? Blue/purple (transitioning/moderate)? Pale (not transitioning- in need of assistance) TONE- Flexed, spontaneous movement (good condition) Floppy (poor condition, requires immediate intervention) BREATHING- 40-60 resps/min (good condition) 100bpm (good, continue to observe)