Newborn Resuscitation: The Golden Minute

    8. If yes, how far apart are your contractions
     As the delivery becomes more imminent, the contractions will progressively be closer together

Table II: Newborn Resuscitation Equipement

    1. OB Kit

    2. Suction equipment
       a. Bulb syringe
       b. 8F feeding tube (gastric decompression)
       c. 20 ml syringe (gastric decompression)
       d. Meconium aspriator
       e. Suction catheters (5,8,10F)

   3. Bag-mask equipment
       a. Neonate bag-valve mask
       b. Various sized masks

   4. ET intubation equipment
       a. Pediatric (small) laryngoscope
       b. Cuffed ET tubes, various sizes from 2.5 to 4.00mm
       c. Small stylets
       d. Securing device
       e. 5F feeding tube to administer ET medications
       f. Neonate stethoscope

   5. Medications
       a. Epinephrine 1:10,000
       b. Normal saline

Table III: Targeted Preductal SpO₂ After Birth²

   1 min 60%-65%
   2 min 65%–70%
   3 min 70%–75%
   4 min 75%–80%
   5 min 80%–85%
   10 min 85%–95%

References

    1. CNN. U.S. birth rate falls for second year in midst of recession. http://articles.cnn.com/2010-08-28/us/birth.rate.decline_1_statistics-center-birth-rate-great-recession?_s=PM:US.

    2. American Academy of Pediatrics. Special report. Neonatal resuscitation: 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2972Ev1.

   3. Helping babies breathe: The golden minute. www.helpingbabiesbreathe.org/index.html.

    4. Aehlert B. Paramedic Practice Today: Above and Beyond. St. Louis, MO: Mosby, 2010.

   5. Kangaroo mother care. www.kangaroomothercare.com/birth.htm.

   6. Caroline N. Emergency Care in the Streets, 6th ed. Sudbury, MA: Jones and Bartlett, 2008.

    7. American Heart Association. Highlights of the 2010 American Heart Association guideline for CPR and ECC. http://guidelines.ecc.org/pdf/90-1043_ECC_2010_Guidelines_Highlights_noRecycle.pdf.

    8. Frascone RJ, Wewerka SS, Griffith KR, Salzman JG. Use of the King LTS-D during medication-assisted airway management. Prehosp Care 13(4):541–545, 2009.

   9. DeBoer S, Seaver M, McNeil M, et al. Prehospital pediatric airway management: It's time to reconsider how we maintain pediatric airways. EMS Mag 38(1):2009.

   10. Stone BJ, Chantler PJ, Baskett PJ. The incidence of regurgitation during cardiopulmonary resuscitation: A comparision between the bag valve mask and laryngeal mask airway. Resuscitation V38 (1): 3–6, May 1998.

   11. Abe KK, Blum GT, et al. Intraosseous is faster and easier than umbilical venous catheterization in newborn emergency vascular access models. Am J Emerg Med 18(2):126–129, 2000.

   12. DeBoer S, Seaver M, Vardi A. Infant intraosseous infusion. Neonatal Network 27(1):25–32, 2008.

   13. Ellemunter H, Simma B, et al. Intraosseous lines in preterm and full term neonates. Arch Dis Child Fetal Neonatal Ed 80(1):F74–75, 1999.

   14. Barbra C, Wyckoff M. Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics 118(3):1028–1034, Sep 2006.

   15. Ting P, Brady JP. Tracheal suction in meconium aspiration. Am J Obstet Gynecol 122:767–771, 1975.

   16. American Heart Association (2009). Worksheet for evidence-based review of science for neonatal resuscitation. www.americanheart.org/downloadable/heart/1265039640057NRP-012A%2031-Jan-2010.pdf.

   17. Wiswell T, Gannon C, Jacob J, et al. Delivery room management of the apparently vigorous meconium-stained neonate: Results of the multicenter, international collaborative trial. Pediatrics 105:1–7, 2000.

   18. American Academy of Pediatrics. The APGAR score. Pediatrics 17(4):1444–1447, 2009.

Scott Tomek, MA, EMT-P, has been a paramedic for 25 years, 23 with Lakeview Hospital EMS in Stillwater, MN. He is a faculty member with the Century College paramedic program, and a curriculum development specialist.