Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis, meconium stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as expected, with very poor tone and he is not breathing (apneic). You quickly perform the initial steps, but the baby is still not breathing. What is the most appropriate next step of resuscitation?
a.Intubate and administer 0.05 mg/kg of endotracheal epinephrine
b.Start positive pressure ventilation and check heart rate response after 15 seconds
c.Start cardiac compressions coordinated 3:1 with the ventilations, and prepared insert an umbilical venous catheter
d.Immediately intubate and suction the trachea

The most important when having to deal with this kind of procedure is planning and preparation, since it is necessary to count on the ideal professional staff and available equipment. Besides it should exist an accurate level of communication between the obstretic and neonatal resuscitation team and one more thing that should be taken into account is the maternal-fetal risk factors in case there are some.

Аноним Аноним · Answer 2 · 2020-03-01T08:05:07+01:00

Answer:

The correct answer is: Start positive-pressure ventilation and check heart rate response after 15 seconds,

Explanation:

When indicated, PPV should begin within 1 minute after delivery.

How do you prepare to start positive pressure ventilation? 1. Eliminate airway secretions. If it is no longer done, suck the mouth and nose to make sure the secretions do not obstruct the PPV.

2. Position yourself next to the baby's head. The person responsible for placing the airways in position and holding the mask on the baby's face is placed on the baby's head.

3. Place the baby's head and neck in the correct position.

The baby's head and neck should be in a neutral position or slightly extended in the sniffing position so that the baby's chin and nose are facing up. The airways will be clogged if the neck is excessively flexed or extended.

How do you evaluate the baby's response to positive pressure ventilation? The most important indicator of a successful PPV is the increase in heart rate. An assistant will monitor the baby's heart rate response with a stethoscope, a pulse oximeter or an electronic heart monitor. Perform 2 assessments of the baby's heart rate response to PPV separately.

Check chest movements with assisted breaths. The heart rate is not increasing; The chest is moving. Announce "The chest IS moving." Continue the PPV that moves to the chest. Perform your second evaluation of the baby's heart rate after 15 more seconds from the PPV that moves the chest. The heart rate is not increasing; the chest is NOT moving. Announce "The chest is NOT moving." The vents are not insufflating the lungs. Perform corrective ventilation steps