NEWBORN RESUSCITATION

ACTIONS/STEPS PREPARATION FOR RESUCITATION

1. Make sure the room/resuscitation trolley is warm Heater ON Heating source if available Treatment surface/table 3-5 clean cloths for drying and wrapping the baby 1-2 to dry the bay 1-2 to wrap the baby after drying 1 to roll under the shoulders for resuscitation (cap where available, blankets where required) Pieces of gauze or clean small pieces of cloth Disposable gloves Suction equipment Suction catheters 8F and 10F with suction machine or DeLee mucous extractor Oxygen cylinder pressure Newborn resuscitation bag with baby face masks (#1 for normal size babies,# 0 for LBW babies) Clock with second hand Stethoscope Thermometer 3. Wash hands and wear gloves

RESUSCITATION (before full delivery of the baby)

1. If there is meconium in the liquor, suction the babys mouth and nose before delivery of shoulders. Explain to the mother what you are doing and asks her not to push for a few seconds.

RESUSCITATION (after full delivery of the baby)

1. If the baby is not breathing, clamp and cut the cord immediately 2. Place the baby on his back in a warm and well-lit surface 3. Wipe the babys face, dry him/her and discard the wet cloth 4. Wrap the babys body and head, leaving the chest exposed, and check again if he/she is breathing. If not breathing, stimulate by rubbing the back and, if necessary, by flicking the soles of the feet (only two to three times- Do not slap repeatedly) Note: In case of meconium stained fluid and the baby is not breathing do not stimulate or ventilate until suctioning the airway 5. Perform steps 1 to 4 quickly (approximately 30 seconds). Adapted from the checklists/jobaids developed by BASICS for Senegal Adapted from the checklists/jobaids developed by BASICS for Senegal 6. If the baby is still not breathing, clear the airway by suction (first the mouth and then the nose) with: a-A DeLee mucous extractor, OR b-A suction tube attached to a mechanical suction device (vacuum pressure no more than 130 cm water or 100 mm Hg). Make sure that: -The suction tube is introduced enough to suction effectively, but no more than 5 cm into the mouth or 3 cm into the nostrils -Suction is applied gently and only when pulling out the tube, not when introducing it. 7. Start ventilation if the baby is still not breathing or he/she is gasping as noted below. 8. Position the babys neck in slight extension by placing a small cloth roll under his/her shoulders 9. Use the proper size mask: #1 for normal size babies,# 0 for LBW 10. Make sure the mask covers and is properly sealed over the babys chin, mouth and nose, but not the eyes. 11. Make sure the babys chest rises and valve of the self-inflating bag moves with each inflation. 12. Ventilate about 40 times/min; reassess the babys breathing after 1 min.

13. Continue ventilation until the baby breathes or cries. 14. If the baby is blue especially in the mouth and tongue, give oxygen if available 15. If the baby does not cry or breathe after 20 minutes discontinue ventilation. 16. After resuscitation, reassess the baby periodically for breathing, color, and activity. If any danger signs are present, refer to the hospital. 17. If the baby improves, keep him/her warm and dry; in skin-to-skin contact with the mother. Defer first bath for at least 6 hours (preferably 24 hrs.) until the baby is stable, warm and breathing normally. Start breastfeeding as soon as the baby is stable and ready to feed.