NRP Umbilical Catheter Placement and Vascular Access 2

Question 1

What is the recommended insertion depth for a UVC in a 3 kg term newborn for emergency delivery room resuscitation?

Accepted Answer

Just until blood is freely aspirated (~2–4 cm from the skin)

Answer

For emergency delivery room use, insert the UVC just until blood can be freely aspirated (~2–4 cm), regardless of birth weight. Precise depth calculation is for elective NICU placement, not emergency access.

Question 2

When preparing an umbilical venous catheter for insertion, which of the following sterile preparation steps is MOST important in the emergency delivery room setting?

Accepted Answer

Applying a sterile field around the umbilicus with povidone-iodine or chlorhexidine cleansing

Answer

In the emergency setting, a sterile field should be established around the umbilicus using antiseptic cleansing. Sterile gloves and a sterile technique are essential. Full surgical preparation may not be possible in a time-critical resuscitation, but basic sterile precautions must be maintained.

Question 3

What is the significance of a UVC that was easy to insert but flushes with resistance and no blood can be aspirated?

Accepted Answer

The catheter may have entered a false passage, portal branch, or become kinked — do not infuse until position is verified

Answer

Inability to aspirate blood combined with resistance to flushing suggests the catheter may be malpositioned — in a false passage, portal branch, or kinked. Medications should not be infused until position is confirmed or the catheter is repositioned.

Question 4

In which clinical scenario would IO access be MOST appropriate during neonatal resuscitation?

Accepted Answer

A newborn with omphalocele requiring emergency vascular access for medications

Answer

Omphalocele is a contraindication to UVC insertion. IO access is the appropriate alternative for emergency vascular access in a newborn with an umbilical abnormality requiring medications.

Question 5

What is the recommended gauge and type of needle for emergency intraosseous access in a full-term neonate?

Accepted Answer

18 gauge IO needle or EZ-IO pediatric needle (15 mm)

Answer

An 18-gauge IO needle or a 15 mm pediatric EZ-IO needle is recommended for neonatal IO access. Standard hypodermic or IV needles are not appropriate as they can bend or be displaced in the bone.

NRP - Neonatal Resuscitation Program Practice Test

NRP - Neonatal Resuscitation Program Practice Test

NRP Umbilical Catheter Placement and Vascular Access 2