Neonatal Resuscitation

2020 ◽  
pp. 64-66
Author(s):  
Anneka Hooft ◽  
Seema Shah
Keyword(s):  
United States ◽  
Emergency Department ◽  
Heart Rate ◽  
Neonatal Resuscitation ◽  
The United States ◽  
Pediatric Emergency ◽  
Positive Pressure ◽  
Respiratory Effort ◽  
Neonatal Resuscitation Program ◽  
Hospital Births

The majority of neonates born in the United States breathe spontaneously and do not require special assistance, but approximately 10% require some intervention, and less than 1% require extensive resuscitation measures. Although the number of infants delivered in the emergency department is unknown, out-of-hospital births have been increasing; thus, pediatric emergency physicians should be prepared for the possibility of a neonatal resuscitation in the emergency department. The acute resuscitation of the neonate should follow the Neonatal Resuscitation Program algorithm and includes assessment of heart rate, color, tone, and respiratory effort within the first minute of life. Initial treatment requires warming and gentle stimulation. Positive pressure ventilation should be initiated if the heart rate is <100 beats per minute, and chest compressions should be initiated if the heart rate is <60 beats per minute.

Neonatal Resuscitation

2021 ◽  
pp. 177-182
Author(s):  
Sarah Nizamuddin
Keyword(s):  
Heart Rate ◽  
Respiratory Distress ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Respiratory Effort ◽  
Chest Compressions ◽  
Adequate Ventilation

After birth, the neonate must be immediately examined to evaluate the need for further resuscitation. Presence of an adequate respiratory effort and heart rate is vital, in addition to adequate tone and temperature. Warm, dry, and closely monitor the infant immediately after birth. Give positive pressure ventilation if there are any signs of respiratory distress or bradycardia. Low heart rate in a neonate is almost always due to hypoxia, so establish adequate ventilation as soon as possible in these cases. In cases of continued bradycardia, chest compressions and medication (epinephrine) may be necessary. Following resuscitation, transfer the neonate to an appropriate unit for continued monitoring.

Heart rate changes during positive pressure ventilation after asphyxia-induced bradycardia in a porcine model of neonatal resuscitation

2018 ◽  
Vol 104 (1) ◽  
pp. F98-F101 ◽  
Author(s):  
Maria Liza Espinoza ◽  
Po-Yin Cheung ◽  
Tze-Fun Lee ◽  
Megan O’Reilly ◽  
Georg M Schmölzer
Keyword(s):  
Heart Rate ◽  
Chest Compression ◽  
Positive Pressure Ventilation ◽  
Porcine Model ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Term Newborn ◽  
Newborn Piglets ◽  
Severe Bradycardia ◽  
Neonatal Resuscitation Program

BackgroundThe Neonatal Resuscitation Program (NRP) states that if adequate positive pressure ventilation (PPV) was given for a low heart rate (HR), the infant’s HR should increase within the first 15 s of PPV.ObjectiveTo assess changes in HR in piglets with asphyxia-induced bradycardia.MethodsTerm newborn piglets (n=30) were anaesthetised, intubated, instrumented and exposed to 50 min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the tube until severe bradycardia (defined as HR at <25% of baseline). This was followed by 30 s adequate PPV and chest compression thereafter. Changes in HR during the 30 s of PPV were assessed and divided into four epochs (0–10 s, 5–15 s, 10–20 s and 20–30 s, respectively).ResultsIncrease in HR >100/min was observed in 6/30 (20%) after 30 s of PPV. Within the epochs 0–10 s, 5–15 s or 10–20 s no piglet had an increase in HR >100/min. Additional 10/30 (33%) had a >10% increase in HR.ConclusionIn contrast to NRP recommendation, adequate PPV does not increase HR within 15 s after ventilation in piglets with asphyxia-induced bradycardia.

scholarly journals Pediatric Emergency Department Responses to COVID-19: Transitioning From Surge Preparation to Regional Support

2020 ◽  
pp. 1-7
Author(s):  
Emily A. Hartford ◽  
Ashley Keilman ◽  
Hiromi Yoshida ◽  
Russell Migita ◽  
Todd Chang ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Pediatric Patients ◽  
The United States ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
The Novel ◽  
Global Pandemic ◽  
The World ◽  
Novel Coronavirus

ABSTRACT In the midst of a global pandemic, hospitals around the world are working to meet the demand for patients ill with the 2019 coronavirus disease (COVID-19) caused by the novel coronavirus first identified in Wuhan, China. As the crisis unfolds, several countries have reported lower numbers as well as less morbidity and mortality for pediatric patients. Thus, pediatric centers find themselves pivoting from preparing for a patient surge to finding ways to support the regional response for adults. This study describes the response from 2 West Coast freestanding academic children’s hospitals that were among the first cities in the United States impacted during this pandemic.

scholarly journals Low-Value Diagnostic Imaging Use in the Pediatric Emergency Department in the United States and Canada

2019 ◽  
Vol 173 (8) ◽  
pp. e191439 ◽  
Author(s):  
Eyal Cohen ◽  
Jonathan Rodean ◽  
Christina Diong ◽  
Matt Hall ◽  
Stephen B. Freedman ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Diagnostic Imaging ◽  
The United States ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Pediatric Emergency Department Utilization and Reliance by Insurance Coverage in the United States

2017 ◽  
Vol 24 (12) ◽  
pp. 1483-1490 ◽  
Author(s):  
Lauren E. Schlichting ◽  
Michelle L. Rogers ◽  
Annie Gjelsvik ◽  
James G. Linakis ◽  
Patrick M. Vivier
Keyword(s):  
United States ◽  
Emergency Department ◽  
Insurance Coverage ◽  
The United States ◽  
Pediatric Emergency ◽  
Emergency Department Utilization ◽  
Pediatric Emergency Department

scholarly journals Assessment of heart rate changes during positive pressure ventilation in asphyxia induced bradycardia porcine model of neonatal resuscitation

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e59-e60
Author(s):  
Liza Espinoza ◽  
Po-Yin Cheung ◽  
Tze-Fun Lee ◽  
Megan O’Reilly ◽  
Georg Schmolzer
Keyword(s):  
Heart Rate ◽  
Animal Models ◽  
Endotracheal Tube ◽  
Positive Pressure Ventilation ◽  
Porcine Model ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Newborn Piglets ◽  
The Mean ◽  
Neonatal Resuscitation Program

Abstract BACKGROUND The Neonatal Resuscitation Program (NRP) states that if positive pressure ventilation (PPV) was started because a baby had a low heart rate (HR), the baby’s HR should begin to increase within the first 15sec of PPV. However, this recommendation has not been examined in either an animal models nor in the delivery room. OBJECTIVES To assess changes in HR in piglets with asphyxia induced bradycardia. DESIGN/METHODS Term newborn piglets (n=30) were anesthetized, intubated, instrumented, and exposed to 40min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the endotracheal tube until the piglet had bradycardia (defined as HR 25% of baseline); at that time CPR was initiated. As per NRP protocol PPV was immediately started for 30sec followed by chest compression. HR was continuously recorded using an ECG during the whole duration of the experiment. Changes in HR during PPV were assessed and divided into four epochs (0-10sec, 5-15sec, 10-20sec and 20-30sec, respectively) after start of PPV. RESULTS The median (IQR) duration of asphyxia was similar between the groups with 189 (128–291)sec, 126 (70–197)sec, 118 (66–250)sec for 3:1C:V, SI+90 and SI+120 respectively (p=0.37; oneway ANOVA with Bonferroni). At time of start of PPV the mean (SD) HR was 35 (13)/min. An increase in HR >100/min was observed in 6/30 (5%) at 30 seconds of PPV. None achieved changes in HR at the epochs 0-10sec, 5-15sec, or 10-20sec. After 15sec of PPV 13/30 (43%) had a decrease in HR and 11/ 30 (36%) had no change in HR. CONCLUSION Adequate PPV does not increase HR in piglets with asphyxia induced bradycardia. This is contrary to the current NRP, which recommends that after 15 sec of PPV HR should be assessed.

scholarly journals Emergency Department Visits From 2014 to 2018 for Head Injuries in Youth Non-Tackle Football Compared With Other Sports

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097540
Author(s):  
Jessica M. Zendler ◽  
Ron Jadischke ◽  
Jared Frantz ◽  
Steve Hall ◽  
Grant C. Goulet
Keyword(s):  
United States ◽  
Emergency Department ◽  
Head Injury ◽  
Head Injuries ◽  
The United States ◽  
Emergency Department Visits ◽  
Head Region ◽  
Cerebral Contusion ◽  
Common Diagnosis ◽  
Tackle Football

Background: Non-tackle football (ie, flag, touch, 7v7) is purported to be a lower-risk alternative to tackle football, particularly in terms of head injuries. However, data on head injuries in non-tackle football are sparse, particularly among youth participants. Purpose: To describe the epidemiology of  emergency department visits for head injuries due to non-tackle football among youth players in the United States and compare the data with basketball, soccer, and tackle football. Study Design: Descriptive epidemiology study. Methods: Injury data from 2014 to 2018 were obtained from the National Electronic Injury Surveillance System database. Injury reports coded for patients aged 6 to 18 years and associated with basketball, football, or soccer were extracted. Data were filtered to include only injuries to the head region, specifically, the head, ear, eyeball, mouth, or face. Football injuries were manually assigned to “non-tackle” or “tackle” based on the injury narratives. Sports & Fitness Industry Association data were used to estimate annual sport participation and calculate annual injury rates per 100,000 participant-years. Results: A total of 26,770 incident reports from 2014 to 2018 were analyzed. For head region injuries in non-tackle football, the head was the most commonly injured body part, followed by the face; the most common diagnosis was a laceration, followed by concussion and internal injury (defined as an unspecified head injury or internal head injury [eg, subdural hematoma or cerebral contusion]). The most common contacting object was another player. The projected national rate of head region injuries was lowest for non-tackle football across the 4 sports. In particular, the projected rate of injuries to the head for non-tackle football (78.0 per 100,000 participant-years) was less than one-fourth the rates for basketball (323.5 per 100,000 participant-years) and soccer (318.2 per 100,000 participant-years) and less than one-tenth the rate for tackle football (1478.6 per 100,000 participant-years). Conclusion: Among youth in the United States aged 6 to 18 years who were treated in the emergency department for injuries related to playing non-tackle football, the most common diagnosis for injuries to the head region was a laceration, followed by a concussion. Head region injuries associated with non-tackle football occurred at a notably lower rate than basketball, soccer, or tackle football.

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