TYK363

A newborn preterm infant is being evaluated 5 seconds after birth. He is cyanotic (centrally and peripherally), unresponsive, limp, without respiratory effort, and his heart rate is 90 beats per minute. Please select the next BEST course of action and calculate his Apgar score.

a) Begin positive pressure ventilation; Apgar = 2

b) Intubate and begin chest compressions; Apgar = 1

c) Stimulate, clear airway; Apgar = 1

d) Stimulate, clear airway; Apgar = 2

e) Begin positive pressure ventilation; Apgar = 2

f) None of the above

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Answer

Answer c. Following the neonatal resuscitation guidelines, the first 15 seconds should be spent stimulating the infant, clearing the airway, and warming and drying the infant. If the infant is apneic or gasping after 30 seconds, positive pressure ventilation should be initiated along with Spo2 monitoring.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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