新生兒窒息英文PPT學(xué)習(xí)教案

1、會(huì)計(jì)學(xué)1 新生兒窒息英文新生兒窒息英文 The highest mortality that befalls the human race in one day occurs on the day of birth. . It is said that the most important period of the life of a human being is the time spent in utero. The most trying ordeal a human being sustains is the ordeal of birth. Asphyxia Neonatorum:

2、 Causation and Treatment Professor of Obstetrics, Northwestern University Medical School Jos. B. De Lee Published in Medicine (Detroit) 3:643-660, 1897. 第1頁(yè)/共18頁(yè) Hypoxemia, Hypercapnia, Mixed acidosis, Organic failure 第2頁(yè)/共18頁(yè) 第3頁(yè)/共18頁(yè) aspiration FIntrauterine infection: Torch syndrome 第4頁(yè)/共18頁(yè) oxyt

3、ocic medicine 第5頁(yè)/共18頁(yè) 第6頁(yè)/共18頁(yè) 第7頁(yè)/共18頁(yè) Sign0 Points1 Point2 Points Activity (muscle tone) absentarms and legs flexed active movement Pulse (heart rate) absentbelow 100 bpm above 100 bpm Grimace (reflex irritability) no responsegrimacesneeze,cough, pulls away Appearance (skin color) blue-gray, pale

4、 all over normal, /-extremities normal over entire body Respiration absentslow, irregular good, crying A P G A R 第8頁(yè)/共18頁(yè) F Apgar 810, normal; 47, mild asphyxia; 03, severe asphyxia F Assigned at 1, 5, and 10 min, until score of 7 or more F 1 score indicate the severity and guide for resuscitation F

5、 5 score and later is more predictive of prognosis F Premature infants intend to have lower scores 第9頁(yè)/共18頁(yè) 第10頁(yè)/共18頁(yè) F Infant with an Apgar Score of 7 or more generally do not require resuscitation a brief period of oxygen blown over the face oxygen increases pulmonary blood flow avoid excessive su

6、ctioning of clear fluid F Infant with an Apgar Score of 4 to 6 stimulation administration of oxygen by face mask, or bag empty the stomach when using bag or mask ventilation 第11頁(yè)/共18頁(yè) F Infant with an Apgar Score of 1 to 3 usually require intubation and expansion of the lung bag and mask ventilation

7、 usually is adequate to sustain further steps depend on the response to ventilation F Infant with an Apgar Score of 0 no live born infant should be assigned a score of 0 resuscitation should proceed as for a score of 1 cardiac compression 第12頁(yè)/共18頁(yè) Air way Breathing Circulation Drugs Evaluation & En

8、viroment 第13頁(yè)/共18頁(yè) The Neonatal Resuscitatio n GuidelinesPediatrics, 2000 第14頁(yè)/共18頁(yè) MedicationConcentration to Administer PreparationDosage & Route Rate & Precautions Epinephrine 1:10,000 (0.1 mg/l)1 ml0.1-0.3 ml/kg IV or IT Give rapidly, may repeat every 5- 10 minutes. Volume Expanders whole blood,

9、 5% albumin, saline, Ringers lactate Varies10 ml/kg IVGive over 5-10 minutes. Repeat as needed. Sodium Bicarbonate 0.5 meq/ml (4.2% solution) 20 ml or two 10 ml prefilled syringes 2 meq/kg (4 ml/kg) IV Give slowly, over at least 2 minutes, may repeat every 10 minutes. Ventilate infant. Narcan (Nalox

10、one) 0.4 mg/ml1 ml0.1 mg/kg (0.25ml/kg) IV, IM, SQ, IT Give rapidly. Calcium Gluconate 100 mg/ml (10% solution, 0.465 mEq/ml) 10 ml100 mg/kg (1 ml/kg) IV Give over 3-5 minutes, may repeat every 15 min. Do not mix with sodium bicarbonate in line. 第15頁(yè)/共18頁(yè) F Continuing Care of the Newly Born Infant supportive or ongoing care monitoring appropriate diagnostic evaluation F Documentation of Resuscitation F Continuing Care of the Family F Ethics: Noninitiation of Resuscitation Discon