Immediate Care of the Newborn at the Delivery Room

Immediate Care of the Newborn at the Delivery Room
1. Establishment of the respiration
a. With head extension, clear the mouth and nose to prevent meconium aspiration
b. After expulsion
• Place on slight Trendelenburg position (10-15 degree angle) to drain secretions
• Suction briefly:gently from the mouth to the nose, bulb syringe for shallow suctioning
2. Keep warm
a. Dry and wrap newborn to prevent heat loss
b. The newborn’s high temperature at birth is 36.5-37.2C
c. Drops quickly at birth because of losing heat by the process of:
*evaporation
*conduction
*convection
*radiation
      3. APGAR Scoring
A score is given for each sign at one minute and five minutes after the birth. If there are problems with the baby an additional score is given at 10 minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.

Sign 0 Points 1 Point 2 Points
A Activity (Muscle Tone) Flaccid Some flexion Well flexed
P Pulse Absent Below 100 bpm Above 100 bpm
G Grimace (Reflex Irritability) No Response Grimace Sneeze, cough, pulls away
A Appearance (Skin Color) Blue-gray, pale all over Acrocyanosis Completely pink; ruddy
R Respiration Absent Slow, irregular (60 breaths per minute)

Silverman-Anderson Scoring System
Score 0 1 2
• Chest movement synchronized lag on inspiration see-saw movement
• Intercostal Retractions none just visible marked
• Xyphoid Retractions none just visible marked
• Nasal Flaring none minimal marked
• Expiratory Grunting none stethoscope only naked eye and ear

0-no respiratory distress
4-6-moderately depressed
7-10-severely depressed

      4. Proper Identification
a. Bracelets foot tags can be used
b. FOOTPRINTING- best way to identify
c. Identification is done before baby is separated to mother
        5. Check for:
a. Gestational age
b. Birth injuries
c. Congenital defects
d. Gross anomalies...