University of Iowa
Department
of Family Medicine
FPInfo: Resources to support patient care
Disease Specific Resources - Neonatology
Neonatal Rususcitation
Apgar Score
|
|
Score |
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|
Sign |
0 |
1 |
2 |
|
Heart rate Respirations |
Absent Absent |
Slow (<100 beats/min) Slow, irregular |
>100 beats/min Good, crying |
|
Muscle tone |
Limp |
Some flexion |
Active motion |
|
Reflex irritability (catheter in nares, tactile stimulation) |
No response |
Grimace |
Cough, sneeze, cry |
|
Color |
Blue or pale |
Pink body, blue extremities |
Completely pink |
Select the appropriate-sized tube.
|
Tube
Size (mm)
|
Weight (g) |
Gestational Age (wks) |
|
2.5 |
Below 1,000 |
Below 28 |
|
3.0 |
1,000-2,000 |
28-34 |
|
3.5 |
2,000-3,000 |
34-38 |
|
3.5-4.0 |
Above 3,000 |
Above 38 |
Medications for Neonatal Resuscitation
|
Medication |
Concentration to Administer |
Preparation |
Dosage/ |
Total Does/Infant |
Rate/Precautions |
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|
Epinephrine |
1:10 000 |
1 ml |
0.1-0.3 mL/kg
IV or ET |
Weight 1 kg 2 kg 3kg 4kg |
Total mL 0.1-0.3 mL 0.2-0.6 mL 0.3-0.9 mL 0.4-1.2 mL |
Give rapidly Saline to 1-2 mL if giving ET |
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|
Volume Expanders |
Whole blood 5% Albumin-saline Normal saline Ringer’s lactate |
40 mL |
10 mL/kg
IV |
Weight 1 kg 2 kg 3 kg 4 kg |
Total mL 10 mL 20 mL 30 mL 40 mL |
Give over 5-10 minutes |
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|
Sodium Bicarbonate |
0.5 mEq/mL (4.2% solution) |
20 mL or two 10 mL prefilled syringes |
2 mEq/kg IV |
Weight 1 kg 2 kg 3 kg 4 kg |
Total Dose 2 mEq 4 mEq 6 mEq 8 mEq |
Total mL 4 mL 8 mL 12 mL 16 mL |
Give slowly, over at least 2 minutes Give only if infant is being effectively ventilated |
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Naloxone Hydrochloride |
0.4 mg/mL |
1 mL |
0.1 mg/kg (0.25 mL/kg) IV, ET IM, SQ |
Weight 1 kg 2 kg 3 kg 4 kg |
Total Dose 0.1 mg 0.2 mg 0.3 mg 0.4 mg |
Total mL 0.25 mL 0.50 mL 0.75 mL 1.00 mL |
Give rapidly IV, ET preferred IM, SQ acceptable |
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1.0 mg/mL |
1 mL |
0.1 mg/kg (0.1 mL/kg) IV, ET IM, SQ |
1 kg 2 kg 3 kg 4 kg |
0.1 mg 0.2 mg 0.3 mg 0.4 mg |
0.1 mL 0.2 mL 0.3 mL 0.4 mL |
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Dopamine |
Weight Desired dose mg of dopamine 6 x (kg) x (µg/kg/min) = per 100 mL of solution Desired fluid (mL/h)
|
Begin at 5 µg/kg/min (may increase to 20 µg/kg/min if necessary) IV |
Weight
1 kg 2 kg 3 kg 4 kg |
Total µg/min
5-20 µg/min 10-40 µg/min 15-60 µg/min 20-80 µg/min |
Give as a continuous infusion using an infusion pump Monitor heart rate and blood pressure closely Seek consultation |
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*IM, intramuscular; ET, endotracheal; IV, intravenous; SQ, subcutaneous |
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