In neonatal resuscitation for infants under 28 days old, the recommended CPR compression-to-ventilation ratio is 3:1, performed for 60-second intervals before reassessment, which differs from the PALS 15:2 ratio used for children over 28 days old.
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Neonatal resuscitation - CPR ratioAdded:
Now, while resuscitating a newborn infant, you note the heart rate remains at 50 beats per minute despite 30 seconds of positive pressure ventilations. You've initiated CPR.
Which of the following options correctly identifies the recommended compression to ventilation ratio and the total duration of CPR before formal reassessment is performed?
And that's a mouthful.
Would it be A, a 3:1 ratio performed for 30 seconds? B, a 15:2 ratio performed for 2 minutes? C, a 30:2 ratio performed for 60 seconds? Or D, a 3:1 ratio performed for 60 seconds? Now, believe it or not, a lot of students do mess this up. And the reason why they do is honestly I think pals. Pals is something that a lot of EMS students kind of like ingrain in their mind and say, "Hey, you know, this we have two or more rescuers we're going to do 15:2 on this child.
Oh, I'm by myself now I'm doing 30:2."
Now, the pals algorithms are used for children who are greater than 28 days old. I know usually we say 1 month, right? Anything greater than 1 month we're going to consider that to be an infant and anything infant to puberty is in our pals range. Now, any child who is less than that 28-day rule is considered a neonate or a newborn, right? I know newborn by definition is the first few hours after delivery and that's what we are seeing in this test question. So, we are not treating this kid with a pals algorithm. So, looking at B saying 15:2 ratio performed for 2 minutes, that is a pals algorithm. We would go ahead and throw B out.
Next one that we can throw out is a 30:2 ratio performed for 60 seconds. That is again, uh we can perform pals at 30:2 if you are by yourself, but remember we would be doing that for 2 minutes.
Not 60 seconds in pals and again this kid's too young for that. So, we would throw out C as well and that leaves us with a 3:1 ratio, which is the proper ratio for neonatal resuscitation.
But, do we do it for 30 seconds or do we do it for 60 seconds? And the answer to that question is 60 seconds. Whenever we are performing CPR and neonatal resuscitation, we're doing them in 60-second intervals, and after the 60 seconds, we are performing a reassessment. So again, yep, answer here D.
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