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Pediatrics - Neonatal Distress
Whiteboard Animation Transcript
with Abbas Husain, MD and Nicholas Otts, MD
medskl.com/mod...
Neonatal Distress is a challenge, but remembering a few key actions will help you maintain control.
If a newborn baby is not responsive or struggling, the first thing you need to do is to dry and stimulate the baby. Often, this simple action, which includes rubbing the back near the spine and applying a dry towel, is all that is required.
If that doesn’t work, the key principle to remember is that the cause of neonatal distress is most likely a respiratory, or lung, issue. The baby needs to use an organ, the lung, that it has never used before.
The APGAR score is a tool developed to monitor the progress as it is measured at 1 minute and at 5 minutes after birth for all infants, and at 5 minute intervals as needed.
Each category is scored from 0-2.
Appearance (colour)
0 - Body cyanosis
1 - Cyanosis on hands / feet
2 - Pink
Grimace (reflex irritability)
0 - Flaccid
1 - Grimace
2 - Grimace and pull away, cough, or sneeze
Activity (muscle tone)
0 - Limp
1 - Some flexion of arms and legs
2 - Active motion
Respiration (breathing)
0 - Not breathing
1 - Weak cry
2 - Strong cry
That seems like a lot to remember in an emergency, but in short, a blue baby that isn’t breathing is bad, and a pink baby with a strong cry is great.
The two important numbers to remember are 100 and 60. If you warmed and stimulated the baby and the baby is still struggling, measure the pulse.
If less then 100, start breathing for the baby with assisted ventilation.
If that doesn’t work, and baby’s heart rate is now less then 60, begin CPR with chest compressions and call a specialist.