英新生兒窒息與新法復蘇-資料下載頁
2025-05-26 18:19本頁面
【正文】 cannula intubation and susction once should be finished within 20 seconds if the baby has one of the follows ① meconium ropiness or there is granules of meconium hypolarynx ② the baby suffer from severe asphyxia and need artificial ventilating for a long time。 ③ the result is poor using resuscitaing。 ④ the baby heart rate is 80100 pem and doesn’t increase to follows； ⑤ suspect diagnosis of diaphragmatic hernia. anatomic landmark for put in laryngoscope tracheal intubation 4. medicine assisting resuscitation ⑴ alkali therapy ⑵ adrenalin therapy ⑶ vasoactive agent therapy dopamine 35ug/ ⑷ Heparine therapy 2030u/, H, tid ⑸ naloxone antimorphinum and inhibition of HIE. 5． Observe and monitor post resuscitation body temperature, breath, heart rate. Blood pressure, urinary volume, skin color, and symptom of nervous system。 notice acidbase imbalance, electrolyte disturbances, abnormity of urination and defecation, infection and feeding etc. 出生 ?是否足月？ ?是否羊水清？ ?是否有呼吸和哭聲？ ?是否肌張力好？ ?保溫 ? 擺正體位， 通暢氣道 ? 擦干 ,刺激 , 重新擺正體位 評價心率、呼吸和膚色 常壓給氧 常規(guī)護理 ? 保溫 ? 必要時通暢氣道 ? 擦干 觀察護理 是 正常呼吸 心率 100 及 膚色紅潤 否 紫紺 膚色紅潤 2022 NRP 流程圖 Harris AP et al. J Pediatr 1986。109:117 Reddy VK et al. Clin Pediatr 1999。38:87 Toth B et al. Arch Gyn Obst 2022。266:105 正壓人工呼吸 ? 正壓人工呼吸 ? 胸外按壓 給腎上腺素 和 /或 擴容 復蘇后護理 呼吸暫停 HR 100 持續(xù)性紫紺 有效通氣 HR 100 及 皮膚紅潤 HR 60 HR 60 HR 60 * 在某些步驟可考慮氣管插管 Announcements ? Seize every minute and second， obstetrics and pediatric operate together ? Excute the ABCDE procedure strictly ? Respiratory heart rate and skin colour are the tree big physical sign to judge the asphyxia and resusitation 循環(huán)往復，至完成復蘇 → 遵循 六、 preventing antepartum body check periodicly, avoid premature and operation delivery. waiting for delivery fetal heart monitor and discovery early intrauterine distress . intrapartum suck the mucosa out of the baby’s mouth, nose and pharyng (10 seconds) right after birth, get ready for all of resuscitation. 七 prognosis the poor prognosis include: chronic intrauterine hypoxia, congenital abnormity, severe asphyxia without management in time or unsuitable management, Apgar score is low after 20 mins of birth。 nervous system persistence for 2 weeks. thank you listening ?。?
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