LESSON

Preparing for
resuscitation
 LESSON

• What you will learn

• Risk factors that can help predict which babies
will require resuscitation
• How to assemble a resuscitation team
• Four key questions to ask the obstetric provider
before birth
• How to perform a pre-resuscitation team briefing
• How to assemble and check resuscitation
supplies and equipment
 LESSON2

WHY IS IT IMPORTANT TO
ANTICIPATE THE NEED FOR
RESUSCITATION BEFORE
EVERY BIRTH?

Antepartum risk factors
• Gestational age less than
36 0/7 weeks
• Gestational age greater
than or equal to 41 0/7
weeks
• Preeclampsia or
eclampsia
• Maternal hypertension
• Multiple gestation
• Fetal anemia
• Polyhydramnios
LESSON2
• Oligohydramnios
• Fetal hydrops
• Fetal macrosomia
• Intrauterine growth
restriction
• Significant fetal
malformations or
anomalies
• No prenatal care

Intrapartum risk factors
• Emergency cesarean
delivery
• Forceps or vacuum-assisted
delivery
• Breech or other abnormal
presentation
• Category II or III fetal heart
rate pattern*
• Maternal general
anesthesia
• Maternal magnesium
therapy
• Placental abruption
LESSON2
• Intrapartum bleeding
• Chorioamnionitis
• Narcotics administered to
mother within 4 hours of
delivery
• Shoulder dystocia
• Meconium-stained amniotic
fluid
• Prolapsed umbilical cord
 LESSON2

WHAT QUESTIONS
SHOULD YOU ASK
BEFORE EVERY BIRTH?
 LESSON2
4 pre-birth questions

• ❶ What is the expected gestational age?

• ❷ Is the amniotic fluid clear?
• ❸ How many babies are expected?
• ❹ Are there any additional risk factors?
 LESSON2

What personnel should

be present at delivery?

• Every birth should be
attended by at least 1
qualified individual,
• skilled in the initial steps
of newborn care and
• positive-pressure
ventilation (PPV),
• whose only responsibility
is management of the
newly born baby.
LESSON2
• If risk factors are present
at least 2 qualified people
should be present.
• The number and
qualifications of
personnel will vary
depending on the
– anticipated risk,
– the number of babies, and
– the hospital setting.
 LESSON2

• A qualified team with full • Example:

resuscitation skills • During uncomplicated
should be identified delivery, a nurse will
and immediately available evaluate gestation, tone
for every resuscitation. and respiration
– at the time of birth - if
extensive resuscitation
measures is anticipated.
– It is not sufficient to have
the team on call at home /
in a remote area of the
hospital.
• When resuscitation is
needed, it must begin
without delay.
 Perform a pre- Gestation,
resuscitation team Tactile
muscle tone,
briefing. stimulation
respiration

No appropriate
Position & clear
Start PPV response
airway

Get
immediate
help Ongoing
resuscitation
 LESSON2

Perform a pre-resuscitation
team briefing.
 LESSON2

Review risk factor &

Assemble a any management
Identify team
team plan during antenatal leader
counseling

Gather all perinatal discuss the

information to Assign roles &
anticipate possible
possible
responsibility
complication scenarios

Plan your
response
 LESSON2

What supplies and

equipment should be
available?
 LESSON2
Suction equipment