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Respiratory Complications
•Respiratory distress- one of most common problems
•Primary or secondary to conditions affecting ability to breathe
•Neonatal resuscitation
•Four primary assessment questions
•Is the baby term? Is the amniotic fluid clear? Is the baby breathing or crying? Is
there good muscle tone?)
•Risk factors (mat. Obesity, DM, chorio, cord compression, prematurity,
meconium…)
•Primary apnea: rapid respirations followed by cessation of respirations& rapid fall in
heart rate- stimulation, alone or with oxygen, may restart respirations.
•Secondary apnea: O2 continue decrease, loses consciousness, stimulation
ineffective. Resuscitative immediately to prevent permanent injury to the brain or
death
•newborn supine underneath a radiant warmer, drying the newborn, and
stimulating and removing the wet towels- should begin crying or have sustained
breathing.
•If NOT, position newborn’s head to open the mouth/airway, clear the airway
with a bulb suction or catheter, and begin positive pressure ventilation
immediately
•<29w in polyethylene bag up to neck before dried to reduce heat loss from
evaporation, prevent hyperthermia when with chemical warming pad
•hypoxic-ischemic encephalopathy (HIE) after prolonged neonatal resuscitation-
therapeutic hypothermia improve neurologic outcomes, but need >36w, in
facility where treatment can be initiated within 6 hours of birth
