usmletopper2
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what is the management of meconium aspiration,in a baby who is already crying ?i mean what is the first step
suction of oropharyngx and nasopharyngx or tactile stimulation?
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| arlete
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suction
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Now it's on God's hands. I've done my best!
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| usmletopper2
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thtas what i thought but in UW it is given as tactile stimulation as the first step followed by suction has anyone come across this q???????????? 
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| mukho
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no point giving tactile stimulation to baby who is already crying...suction sounds better
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| mumbaimulgi
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The American Academy of Pediatrics Neonatal Resuscitation Program Steering Committee has promulgated the following guidelines for management of the baby exposed to meconium:
If the baby is not vigorous (defined as poor muscle tone and little or absent respiratory effort): Suction the trachea immediately after delivery. Suction for no longer than 5 seconds. If no meconium is retrieved, do not repeat intubation and suction. If meconium is retrieved and no bradycardia is present, reintubate and suction. If the heart rate is low, administer positive pressure ventilation and consider suctioning again later.
If the baby is vigorous (defined as good respiratory effort, crying, good muscle tone, and good color): Clear secretions and meconium from the mouth and nose with a bulb syringe or a large-bore suction catheter. In either case, the remainder of the initial resuscitation steps should ensue: dry, stimulate, reposition, and administer oxygen as necessary
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| usmletopper2
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thanks for the answer,so do we go for suction as the initial step or basic resusitation initially as the baby is active?because that is what is asked in the question and the anwer was
drying and stimulation-----------suction of nasopharyngx---------evaluation of breathing,if poor bag and mask ventillation--------chck HR-------<60---chest compressions medication,,---->60-continue bag and mask
can anyone one outline the basic resusitation steps in an order ?
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| mukho
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basic resuscitation depends on condition of the baby: As we are taught, ask the following-
1.term gestation?
2.clear amniotic fluid?
3.breathing or crying?
4.good muscle tone?
if ans to all are yes---provide warmth--clear airway--dry--assess color (thing is, in real life mostly everything is done together by more than one person present; but for exam that should be the order)
if ans to any is NO--provide warmth---position and clear airway---dry, stimulate, reposition. (in that order...though the warmth is often assumed or already mentioned in the question)
for meconium liquor speciically the vigorous baby vs non vigorous baby come in...
hopefully i didnt complicate the matter any further!
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| mumbaimulgi
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initial reuscitation is to clear secretions by suction---period ---this is followed by everything else----
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