英新生兒窒息與新法復(fù)蘇(參考版)
2025-05-29 18:19本頁面
【正文】 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(fù)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(fù)，至完成復(fù)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。109:117 Reddy VK et al. Clin Pediatr 1999。 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。 Above 5 steps should be finished within 30 seconds after birth. The first resuscitation step keep warm wipe dry tactile stimulus clear airway plete within 30 second after birth correct posture 2. ventilating resuscitation procedure ⑴ if the baby has already normal breath and heart rate＞ 100 pem, the skin is red, just observe him. ⑵ if he has no breath, or only gasp and heart rate ＜ 100 pem, should supply pressurized oxygen with the resuscitator right away, if heart rate is 80一 100 pem and spontaneously breathing occur after 1530 seconds, could continue above step for some time, then observe him. ⑶ if the heart rate can’t increase or ＜ 80 pem. Should carry out pressing heart from outchest for 30 seconds, if no respond, should give 1：10000 adrenalin ／ kg by the way of vein and trachea. ⑷ if the heart still ＜ 100 pem, could give the medicine to correct acidosis and expanse fluid. ⑸ if the mother was given narcotic 6 hrs before birth, could gave the baby
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