Special Resuscitation Circumstances Flashcards

What is the most common cardiac arrhythmia seen in neonates during resuscitation?

Answer: Bradycardia due to hypoxia

Neonatal cardiac arrest is almost always due to respiratory failure leading to hypoxic bradycardia, not primary arrhythmia.

How should resuscitation of a newborn with Pierre Robin sequence be modified?

Answer: Prone positioning may improve airway patency; consider nasopharyngeal airway

Prone positioning uses gravity to move the tongue forward, and a nasopharyngeal airway can bypass the glossoptosis in Pierre Robin sequence.

Which infant is at highest risk for requiring resuscitation at birth?

Answer: Preterm infant at 27 weeks with fetal heart rate decelerations

A 27-week preterm infant with signs of fetal distress has the highest combination of risks: immaturity and acute compromise.

What is therapeutic hypothermia and when is it indicated after neonatal resuscitation?

Answer: Cooling to 33–34°C for 72 hours in ≥36-week infants with moderate–severe HIE

Therapeutic hypothermia (33–34°C for 72 hours) is indicated for ≥36-week infants with moderate-to-severe hypoxic-ischemic encephalopathy (HIE).

A newborn is born with a pneumothorax causing deterioration. What emergency bedside procedure is performed?

Answer: Needle thoracentesis at the 2nd intercostal space, midclavicular line

Emergency needle thoracentesis at the 2nd intercostal space midclavicular line (or 4th–5th intercostal space anteriorly) rapidly decompresses a tension pneumothorax.

Which prenatal condition places a newborn at greatest risk for pulmonary hypertension requiring specialized resuscitation?

Answer: Prolonged oligohydramnios causing pulmonary hypoplasia

Prolonged oligohydramnios restricts lung growth, resulting in pulmonary hypoplasia and persistent pulmonary hypertension at birth.