新生儿窒息复苏--双语_.pptVIP

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新生儿窒息复苏--双语_.ppt

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新生儿窒息复苏--双语_

Resuscitation of Neonatal Asphyxia Qiuji Tao 2011.7.29 学习目标 Neonatal Resuscitation Process 掌握新生儿窒息复苏流程 Summary of Key Issues and Major Changes 了解窒息复苏新进展 overview 19% of the newborns die because of asphyxia over the world. Most (90%) of the Newborns are viable. A minority (fewer than 10%) of newlyborn infants require a little help to establish breath. Only 1% need further resuscitation to live. Neonatal asphyxia recovery process neonatal resuscitation can be divided into four steps (4 for 30 seconds), 2 minutes rapid assessment ---30s positive pressure artificial respiration ---30s chest compressions ----30s use of epinephrine ---30s 第一个30秒(新生儿快速综合评估) 第三个30s(人工呼吸+胸外按压) 30秒正压人工呼吸后心率仍低于60 bpm 第四个30s(给肾上腺素) 有效的正压人工呼吸30sec + 30sec胸外按后心率仍在﹤60次/分快速评估初步复苏 Summary of Key Issues and Major Changes Neonatal cardiac arrest is predominantly asphyxial, so the A-B-C resuscitation sequence with a 3:1 compression-to-ventilation ratio has been maintained except when the etiology is clearly cardiac. 胸外按压指征：30s正压人工呼吸后仍无心率或心率持续?60次/min。按压深度为前后胸直径的1/3。 Assessment of Heart Rate, Respiratory Rate,and Oxygenation 2010 (New): Assessment of Heart Rate, Respiratory Rate,and Oxygenation 2005（旧）：在 2005 版本中，根据心率、呼吸速率和肤色评估结果进行评估。 Why: Assessment of color is subjective. There are now data regarding normal trends in oxyhemoglobin saturation monitored by pulse oximeter. Supplementary Oxygen 2010 (New): For babies born at term, it is best to begin resuscitation with air rather than 100% oxygen. 2005 (Old): If cyanosis, bradycardia, or other signs of distress are noted in a breathing newborn during stabilization, administration of 100% oxygen is indicated. Supplementary Oxygen Why: Evidence is now strong that healthy babies born at term start with an arterial oxyhemoglobin saturation of 60% and can require more than 10 minutes to reach saturations of 90%. Hyperoxia can be toxic, particularly to the preterm baby