英新生兒窒息與新法復(fù)蘇-文庫吧資料
2025-06-01 18:19本頁面
【正文】 naloxone ／ kg by the way of vein and trachea. 3. resuscitation technique ⑴ resuscitator supply pressurizing oxygen ventilating rate 3040 rimes, press : relax is 1：, if last for 2 mins, should insert a gastric tube, ⑵ pressing heart out chest the lower l/3 of the breast bone, 120 pem, every pressing 3 times, should supply pressurize oxygen once. Press about l一 2 cm dept, the finger shouldn’t left the pressing location； 雙拇指并排或重疊于患兒 胸骨體下 1/3處，其他手指 繞胸廓托在背后 The way of thumbs 右手中、食指指端垂直壓胸 骨下 1/3處，左手托患兒背部 The way of double fingers ⑶ oral trachea 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。 ⑶ arrange posture pad the shoulder for 23 cm ⑷ suck the mucosa out of the baby’s mouth, nose and pharyng (10 seconds) right after birth。 (一 )ABCDE resuscitation program A (air way) ： B (breathing) C (Circulation) D (drug) E (evaluation) ABC is the most important, and A is basic, B is the key point. (二 ) resuscitation procedure 1． The first resuscitation step ⑴ keep body warm extreme infrared ray table。 severe case presence cardiac shock (CS), heart failure and persistent fetal circulation. 2. respiratory system (RS) Aspiration of amniotic fluid or meconium syndrome, pneumorrhagia and persistent pulmonary hypertension, LBWI may presence hyaline membrane disease and apnea etc. 3. Kidney acute renal failure (ARF, oliguria, proteinuria, Blood urea nitrogen and creatinine increase)。10 min. Skin color cyanose/pale Body red, limbs cyanose Red all over 0～ 3 severe asphyxia 4～ 7 mild asphyxia 8～ 10 normal Judge Prognosis .(time/min) no 100 100 Reaction after stimulate sole or intubate no Some action Cry, sneeze muscular tension laxitas Limbs flex a little Limbs active respiration no slow,irregular normal,cry loudly Asphyxia diagnostic code AAP(美國兒科學(xué)會 ) amp。 glucagon release early↑→ blood sugar normal or ↑then glycogen depletion, blood sugar↓ ? Hyperbilirubinemia Bilirubin bine with albumin↓、 the vigor of liver enzyme↓→unconjugated bilirubin↑ ? Hyponatremia atrial natriuretic peptide, ADH is parasecretion→diluted hyponatremia ? Hypocalcemia calcium channel open、 calcium pump dysfunction →calcium influx ↑ Blood biochemistry and metabolism alteration 三 Clinical situation (一 ) intrauterine asphyxia 1. e
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