Summary of Study Session 7
In Study Session 7, you have learned that:
- The most important signs of asphyxiation in newborns at delivery are: difficulty breathing, gasping or no breathing; abnormal heart beat; poor muscle tone (floppy limbs); lack of movement; bluish skin colour (cyanosis), and being stained with meconium.
- Assessment of the degree of asphyxia should be done in the first 5 seconds after the birth, at the same time as commencing basic newborn care (e.g. drying the baby, keeping it warm, tying and cutting the cord, etc).
- Swift action is necessary to begin resuscitating a baby who is not breathing well, after you have suctioned its mouth and then its nose.
- Check that the baby is alive (listen for an apical heartbeat); that the heart rate is above 60 beats/minute (begin heart massage before resuscitation if the heart rate is less than 60 beats/minute); and that the baby is not stained with meconium, which must be suctioned out before resuscitation can begin.
- Position the baby with its neck extended to open the airways; place a correctly fitting ventilation mask over the baby’s mouth and nose, and begin ventilating at a rate of about 40 breaths per minute.
- Watch for signs of improvement: e.g. pinkish colour, movement, ability to breathe unaided, etc. Refer urgently if this has not been achieved after 30 minutes of ventilation.
- Remember to conduct all the activities of essential newborn care, including cord care, giving a vitamin K injection and tetracycline eye ointment, establishing early and exclusive breastfeeding, and ensuring that anti-HIV medication is given to prevent mother-to-child-transmission.