英-新生儿窒息及新法复苏5.pptVIP

Neonatal Asphyxia and its New Concept on Resuscitation Chongmin Xu Dep.Newnates Union Hospital Pathophysiology Switch of respiration circulation from fetus to newborn are blocked Breath alter biochemistry metabolism alter in blood Hypoxia-ischemia alter in difference organs as asphyxia Asphyxia diagnostic code AAP(美国儿科学会) ACOG(妇产科学会)1996 Announcements Seize every minute and second，obstetrics and pediatric operate together Excute the ABCDE procedure strictly Respiratory heart rate and skin colour are the tree big physical sign to judge the asphyxia and resusitation ⑶ if the heart rate can’t increase or ＜ 80 pem. Should carry out pressing heart from out-chest for 30 seconds, if no respond, should give 1：10000 adrenalin 0.1-0.3ml／kg by the way of vein and trachea. ⑷ if the heart still ＜100 pem, could give the medicine to correct acidosis and expanse fluid. ⑸ if the mother was given narcotic 6 hrs before birth, could gave the baby naloxone 0.1mg／kg by the way of vein and trachea. 3. resuscitation technique ⑴ resuscitator supply pressurizing oxygen ventilating rate 30-40 rimes, press : relax is 1：1.5, if last for 2 mins, should insert a gastric tube, ⑵ pressing heart out chest the lower l/3 of the breast bone, 120 pem, every pressing 3 times, should supply pressurize oxygen once. Press about l一2 cm dept, the finger shouldn’t left the pressing location； 双拇指并排或重叠于患儿 胸骨体下 1/3处，其他手指 绕胸廓托在背后 The way of thumbs 右手中、食指指端垂直压胸 骨下 1/3处，左手托患儿背部 The way of double fingers ⑶ oral trachea cannula intubation and susction once should be finished within 20 seconds if the baby has one of the follows ① meconium ropiness or there is granules of meconium hypolarynx ② the baby suffer from severe asphyxia and need artificial ventilating for a long time; ③ t