What are the emergency care measures for neonatal asphyxia?

There are two main ways for newborns to be born, cesarean section and natural birth. Each delivery method will have accidents, the most serious of which is neonatal asphyxia. The main reason for this phenomenon is that asphyxia has occurred in the uterus before birth, and the second is asphyxia caused by infection at birth. After this phenomenon occurs, emergency care for asphyxia should be carried out to avoid accidents of death of newborns. So what are the emergency care measures for neonatal asphyxia?

Rescue and care after fetal delivery:

Keep warm

After the newborn is delivered, it is immediately placed on a preheated infrared radiation table and the skin all over the body is wiped dry. The temperature in the delivery room is generally between 20℃ and 30℃. All newborns are susceptible to heat loss and depression, and newborns in an asphyxiated state have unstable regulatory functions and are more susceptible to hypothermia. Hypothermia can lead to hypoxemia, hypercapnia, and acidosis, impeding effective resuscitation.

Clearing the airways

Immediately after delivery, the amniotic fluid characteristics, respiration, skin color, muscle tone, and neonatal maturity are assessed. Preserve the umbilical cord (cut the umbilical cord about 10 cm above the umbilical cord) and establish a clear airway and spontaneous breathing. The key to successful neonatal resuscitation lies in effective ventilation and correction of hypoxemia, acidosis, and bradycardia. Once the fetal head is delivered, squeeze out the secretions in the mouth and nose by hand. After the fetal body is delivered, immediately use a neonatal electric suction pump connected to a No. 12 suction tube to suction at 100 times/min. At this time, the child's skin color quickly turns red, the heart rate increases, and the hypoxia state is relieved.

Post-resuscitation observation care:

Insulation

When using an incubator, attention should be paid to the fact that the skin moisture evaporates frequently and newborns are prone to water loss and corneal dryness. Therefore, 30 ml/(kg·d) of additional fluid should be given and attention should be paid to protecting the eyes.

Controlled oxygen delivery

At present, we use pediatric masks to administer oxygen. After the oxygen is humidified, it is input into the mask so that the oxygen opening is as close to the mouth and nose of the sick child as possible. The mask is made of transparent plastic, which is convenient for observing the condition of the patient, but attention should be paid to the regulation of oxygen concentration, because both hypoxia and hyperoxia are very harmful to newborns. Hypoxia can cause tachycardia and acidosis, and hyperoxia can cause retrolental fibrosis. Therefore, oxygen administration to newborns, especially premature infants, should be adjusted based on blood gas results. After resuscitation, oxygen inhalation should be given for 3 to 6 hours depending on the child's condition. Oxygen can be given intermittently until the cyanosis disappears or the breathing becomes stable. The oxygen concentration should be 40% to 50%. Keep quiet and move as little as possible to avoid causing or aggravating intracranial hemorrhage. This body position can slightly elevate the head and shoulders, lower the abdominal viscera, and increase the chances of chest cavity expansion, while also reducing the burden on the heart and intracranial pressure.

Provide fluid replacement, anti-infection, hemostasis, acid correction and other treatments according to doctor's orders

The rate of fluid replacement should not be too fast, 8 to 12 drops/min is appropriate, so as to avoid excessive infusion in a short period of time, which will increase the burden on the heart and cause heart failure and pulmonary edema. Depending on the situation, fluids can be maintained for intravenous medication and emergency treatment. If the condition permits, try to suck and start breastfeeding as early as possible. Because breast milk is rich in trace elements, multiple amino acids, immune factors, globulins, etc., it can promote the growth and development of newborns, defend and resist the invasion of external pathogenic factors, and is beneficial to the recovery of the disease. Furthermore, breast milk has an appropriate temperature, which is beneficial to the gastrointestinal absorption of the newborn and can prevent diarrhea in children. Avoid excessive movement after feeding, slightly raise the back of the head when feeding, stand upright and pat the back after feeding, sleep on the right side to prevent vomiting. For those who cannot suck, use a dropper or tube feeding to feed breast milk.

The emergency care measures for neonatal asphyxia should be based on the condition of the newborn. The doctor will perform the correct first aid, and the newborn's family should pay attention to the follow-up care. When a newborn baby suffers from asphyxia after birth, various physical indicators will be affected. The child must receive regular hospital care and treatment and can only be discharged from the hospital when his condition stabilizes and there are no abnormalities in the body. Because the brain of a newborn baby will be stimulated when it is asphyxiated, brain disease may occur.