Pediatric emergency medicine trisk 0238 0238

FIGURE 9.18 Meconium aspiration radiograph.

Assessment of Heart Rate
Use a 3-lead ECG for rapid and accurate assessment of heart rate during the
resuscitation of term and preterm newborns. Clinical assessment (auscultation of
the precordium) with pulse oximetry used as an adjunct to provide noninvasive
continuous assessment of HR during resuscitation has been shown to be
unreliable and inaccurate. Pulse oximeter use is be reserved for continuous
evaluation of the newborn’s oxygenation.

Assessment of Need for Supplemental Oxygen
Pulse oximetry should be used during resuscitation, during administration of PPV,
when supplemental oxygen is administered, or when central cyanosis persists
beyond the first 5 to 10 minutes of life.

UMBILICAL CORD MANAGEMENT
Evidence has emerged in recent years to suggest that delayed cord clamping
(DCC) is favorable for newly born infants who do not require immediate
resuscitation. Specifically, DCC is associated with less IVH, higher blood
volume, higher blood pressure, less need for blood transfusion, and less
necrotizing enterocolitis (NEC). To date, there is no evidence of decreased