Neonatal Special Considerations

Special considerations for neonatal patients: 1. Higher FiO2s are associated with increased morbidity and mortality. Start FiO2 low and allow it to rise slowly if needed. 2. Delivery room resuscitation should be done without the tail on the AMBU-bag or at 2.5 LPM, and adjusted to reach target SpO2 3. If patient is using expiratory muscles, try decreasing I-time slightly. Be cautious of airtrapping with rates above 40 in larger patients >8kg. If inspiratory time becomes too short, consider switching to PRVC. 4. Suspected PPHN: a. Target SpO2 = 96 – 99% b. Consider pre and post-ductal SpO2s - Pre-ductal: SpO2 = right arm ABG = R. Radial artery - Post-ductal: SpO2 = feet ABG = umbilical artery c. PO2 difference >15mmHg= R. to L. shunt of of Ductus Arteriosis. 6. Suspected Cyanotic Heart Disease: a. Consider 100% O2 challenge. b. If no response in neonate with no respiratory distress, transfer patient to hospital with neonatal intensive care unit. 7. Glucose should be >30 or >20 for premie.