新生儿急救窒息与复苏 课件.ppt

* Flow-inflating bags have a flow-control valve that can be adjusted to deliver the desired peak pressure and positive end-expiratory pressure (PEEP). A pressure manometer attached to the bag will allow proper adjustment of the valve. * The T-piece resuscitator has 2 controls to adjust the inspiratory pressure. The inspiratory pressure control sets the amount of pressure desired during a normal assisted breath. The maximum pressure relief control is a safety feature that prevents the pressure from exceeding a preset value (usually 40 cm H2O, but adjustable). Excessive pressure can also be avoided by watching the circuit pressure gauge. * For the mask to be the correct size, as pictured in this slide, the rim will cover the tip of the chin, the mouth, and the nose, but not the eyes. If the mask is too large, it may cause eye damage. If the mask is too small, it will not cover the mouth and nose and may occlude the nose. * Care should be taken in holding the mask on the newborn’s face. Observe the following precautions. * During the initial stages of resuscitation, breaths should be delivered at a rate of 40 to 60 breaths per minute or slightly less than once a second. If you squeeze the bag or occlude the PEEP cap of the T-piece resuscitator on “Breathe” and release while you say “Two, Three,” you probably are ventilating at a proper rate. Check the 4 signs for improvement (rising heart rate, improving color, spontaneous breathing, and improving tone) after 30 seconds of administering positive-pressure ventilation. As the heart rate increases toward normal, ventilation should be continued at a rate of between 40 and 60 breaths per minute. With improvement, the newborn should become pink and muscle tone should improve. When the heart rate stabilizes above 100 bpm, reduce the rate and pressure of assisted ventilation until you see effective spontaneous respiration. When color improves, supplemental oxygen can also be weaned as tolerated. If the heart rate remains