Nếu vẫn không có phản ứng (1) Tranh thủ một người thứ 2 để giúp kiểm soát đường hô hấp và lặp lại hơi thở thổi phồng. (2) Kiểm tra hầu họng dưới tầm nhìn trực tiếp để đánh giá liệu hút là cần thiết, lặp lại hơi thở lạm phát. | Neonatal resuscitation 189 Neonatal Life Support algorithm Dry the infant remove any wet clothing and cover . .L . Initial assessment at birth start the clock Assess colour tone breathing HR. I If not breathing I . Control the airway with head in neutral position 1 Support the breathing 5 inflation breaths each 2-3s in duration . Confirm a response in HR or visible chest movement. . 1 If there is no response Check head position and apply jaw thrust. 5 inflation breaths. Confirm a response with in HR or visible chest movement. If there is still no response 1 Enlist a 2nd person to help with airways control and repeat inflated breaths. 2 Inspect the oropharynx under direct vision to assess if suction is needed repeat inflation breaths. 3 Insert oropharyngeal Guedel airways and repeat inflation breaths. 4 Consider intubation. Confirm a response in HR or visible chest movement. I When the chest is moving Continue the ventilation breaths if no spontaneous breathing. I Check the HR If the heart is not detectable or slow 60 bpm and not . I Start chest compressions First confirm chest movement if chest not moving return to airways. 3 chest compressions to 1 breath for 30 s. Reassess HR If improving stop chest compressions and continue ventilation if not breathing. If the heart is still slow continue ventilation and chest compressions. Consider venous access and drugs at this stage. APPENDICES 190 Formal assessment of the neonate at birth APPENDICES All neonates are graded with an APGAR score at birth. This is a scoring system out of 10 based on A Activity. P Pulse. G Grimacing reflex irritability on suctioning. A Appearance. R Respiratory effort of the baby. 7-10 is considered normal. 4-7 might require some resuscitative measures. 3 requires immediate resuscitation. Sign 0 points 1 point 2 points A Activity No movement Arms and legs flexed Active movement P Pulse Absent 100 bpm 100 bpm G Grimacing reflex irritability No response Grimace Pulls away A Appearance Blue pale .
