Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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Reference Manual<br />
Clearing of the Airways<br />
• If the baby is still not breathing, clear the airways by suction. Make sure that:<br />
o The suction tube is introduced enough to suction effectively, but no more than 5 cm into<br />
the mouth or 3 cm into the nostrils. Suction the mouth before the nostrils because if the<br />
nose is suctioned first, it may stimulate the baby to breathe <strong>and</strong> if there is thick mucus<br />
in the mouth/throat, it may get inhaled or aspirated.<br />
o Suction should be carried out gently <strong>and</strong> only when pulling out the tube, not when<br />
introducing it.<br />
o Suction should not be applied for more than 20 seconds.<br />
• Re-examine the baby. If the baby starts to cry or breathe well, proceed with routine<br />
essential care of the newborn.<br />
• If the baby is still not breathing or is just gasping, carry out the steps noted below.<br />
Tactile Stimulation<br />
Usually stimulation through proper drying <strong>and</strong> suctioning of the mouth <strong>and</strong> nose are adequate.<br />
At the most, if the baby is still not breathing, very brief additional stimulation by flicking or<br />
slapping the soles of the feet may be tried before commencing ventilation with the bag <strong>and</strong><br />
mask. Perform these steps quickly. All the above steps should take approximately 30 seconds.<br />
Do not slap repeatedly; it is not only harmful but will also waste precious time which could be<br />
better used in ventilating the baby as noted below.<br />
Figure 8.6. Methods for stimulating the baby.<br />
Ventilating the <strong>Newborn</strong> with the Bag <strong>and</strong> Mask<br />
• All the above steps should be carried out quickly to ensure that ventilation where required<br />
is started within one minute after birth.<br />
• Verify that the baby’s neck is in slight extension, either held in position with a h<strong>and</strong> or by<br />
placing a small cloth roll (2.5 cm-3.0 cm) under the shoulders (whichever is more<br />
convenient for the care provider).<br />
• Use the proper size mask:<br />
o Use #1 for normal size babies <strong>and</strong> #0 for LBW babies.<br />
o Make sure the mask covers the baby’s chin, mouth, <strong>and</strong> nose, but not the eyes (see<br />
Figure 8.7).<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
101
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