Tuesday, 1 May 2012

Basic newborn complicatations and emergencies - Tine Grieve

* Ther should never be a surprise low apgar score all observations should tell you how the baby is.
* There should only ever be fatal illnesses causing low apgar e.g. heart defects and lung defects
* To use our intuition, eyes, ears, hands, smell and ears , this is what gives us clues to what is happening in the womb .
* To fully rely on machines is to rely on a totally fallible information source
* A pinard tells us - the beat of the heartbeat and the quality of the heartbeat
* A heartbeat is so much more than a frequency it is much more of a feeling
* The pinard gives the feeling of an irregular heartbeat and also shows the changes when you move the baby- you must listen before , during and after the rushes
* We do not want to hear late decelerations
* We want accellerations at the same time as rush and then decellerations as the rush ends.
* To listen after rush shows how the baby is recovering from lack of oxygen. If the rate decellerates later than the end of the rush then the baby is not recovering properly and needs attention.
* If the baby comes out flat then we need wait to let the baby recover from the rush and lack of oxy gen.
* keep the cord intact because this is the babies life support system
* The first 60 seconds we need to remember to let the baby recover from being born - especially if the babies heart pattern is healthy right up until the birth.
* If the babies heart rate is low during labor and birth and comes out flat and starved  of oxygen- these babies can crash at the breast 5 minutes later
* If the heartrate sounds muffled then be aware that there may be after birth difficulties
* If you know how to use the pinard correctly it is safer than the doppler
* At the beginning of labor- listen for 15mins at 5 min intervals
* In the middle of labor- listen for 5mins before during and after rushes
* At the end of labor listen when you feel that you need to
*                             LISTEN ATTENTIVELY - FEEL THE HEARTBEAT


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