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You are called to the
delivery room in response
to fetal distress and
suspected abruption at
term.
What should your team do
before the neonate is
delivered?
Screen text
Quiz_question
You were asked, “What should your
team do before the neonate is
delivered?”
6-1Q
Check all resuscitation
equipment
Quiz_option
You answered, “Check all
resuscitation equipment.” The need
for extensive resuscitation should
be anticipated given the history of
motor vehicle trauma, vaginal
bleeding and late decelerations.
Checking all resuscitation
equipment is an important task. All
of the tasks listed should be
completed if time allows prior to
delivery.
The need for extensive
resuscitation should be
anticipated given the history of
motor vehicle trauma, vaginal
bleeding and late
decelerations. Checking all
resuscitation equipment is an
important task. All of the tasks
listed should be completed if
time allows prior to delivery.
6-1Q
Prepare to deliver positive
pressure ventilation
Quiz_option
You answered, “Prepare to deliver
positive pressure ventilation.” The
need for extensive resuscitation,
including positive pressure
ventilation, should be anticipated
given the history of motor vehicle
trauma, vaginal bleeding and late
decelerations. All of the tasks listed
should be completed if time allows
prior to delivery.
The need for extensive
resuscitation, including
positive pressure ventilation,
should be anticipated given
the history of motor vehicle
trauma, vaginal bleeding and
late decelerations. All of the
tasks listed should be
completed if time allows prior
to delivery.
6-1Q
Move the code cart into the
room
Quiz_option
You answered, “Move the code cart
into the room.” The need for
extensive resuscitation should be
anticipated given the history of
motor vehicle trauma, vaginal
bleeding and late decelerations.
Moving the code cart into the
delivery room is reasonable. All of
the tasks listed should be
completed if time allows prior to
delivery.
The need for extensive
resuscitation should be
anticipated given the history of
motor vehicle trauma, vaginal
bleeding and late
decelerations. Moving the
code cart into the delivery
room is reasonable. All of the
tasks listed should be
completed if time allows prior
to delivery.
.
6-1Q
All of the above
Quiz_option_right
6-0
6-1Q
Video Name
Per
cent
(A)
Go to Step (A)
6-1Q
100
6-2
Per
cent (B)
Go to
Step
(B)
Text to add to Summary
Wrong Answer Feedback
You are called to the delivery room
in response to fetal distress and
suspected abruption at term.
You correctly answered, “All of
the above.” The need for
extensive resuscitation can be
anticipated given the history of
motor vehicle trauma, vaginal
bleeding and late decelerations.
All of the tasks listed should be
completed if time allows prior to
delivery.
6-2
6-2.mov
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6-3
6-3
6-5Q
6-3.mov
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Quiz_question
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6-5Q
What should you do next?
6-5Q
Intubate
Quiz_option
6-5Q
Catheterize the umbilical
vein
Quiz_option
6-5Q
Request additional help
Quiz_option_right
You were asked, “What should you
do next?”
You answered, “Intubate.” Based on
the patient’s history and clinical
presentation it is imperative to
anticipate that extensive
resuscitation will be required. While
establishing a secure airway with an
endotracheal tube is an important
step in that resuscitation, other
interventions will be required. To
accomplish these interventions
expeditiously and effectively,
additional trained hands will be
required. The sooner the call for
help is made the faster that help will
arrive.
You answered, “Catheterize the
umbilical vein.”
Based on the patient’s history and
clinical presentation it is imperative
to anticipate that extensive
resuscitation will be required. While
establishing intravenous access
with an umbilical catheter is an
important step in that resuscitation,
other interventions will be required.
To accomplish these interventions
expeditiously and effectively,
additional trained hands will be
required. The sooner the call for
help is made the faster that help will
arrive.
100
6-5
You correctly answered, “Request
additional help.” Based on the
patient’s history and clinical
Based on the patient’s history
and clinical presentation it is
imperative to anticipate that
extensive resuscitation will be
required. While establishing a
secure airway with an
endotracheal tube is an
important step in that
resuscitation, other
interventions will be required.
To accomplish these
interventions expeditiously
and effectively, additional
trained hands will be required.
The sooner the call for help is
made the faster that help will
arrive.
.
Based on the patient’s history
and clinical presentation it is
imperative to anticipate that
extensive resuscitation will be
required. While establishing
intravenous access with an
umbilical catheter is an
important step in that
resuscitation, other
interventions will be required.
To accomplish these
interventions expeditiously
and effectively, additional
trained hands will be required.
The sooner the call for help is
made the faster that help will
arrive.
presentation extensive
resuscitation requiring a number
of invasive procedures should be
anticipated. To accomplish these
interventions expeditiously and
effectively, additional trained
hands will be required. The
sooner the call for help is made
the faster that help will arrive.
6-5Q
6-5
6-6Q
Call the blood bank for
blood
6-5.mov
What should you do next?
You answered, “Call the blood bank
for blood.” Based on the patient’s
history and clinical presentation it is
imperative to anticipate that
extensive resuscitation will be
required. While anticipating the
need for blood is an important step
in that resuscitation, other
interventions will be required. To
accomplish these interventions
expeditiously and effectively,
additional trained hands will be
required. The sooner the call for
help is made the faster that help will
arrive.
Quiz_question
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6-6Q
Intubate with a 3.5
endotracheal tube
Quiz_option_right
6-6Q
Ask the second nurse to
Quiz_option
Based on the patient’s history
and clinical presentation it is
imperative to anticipate that
extensive resuscitation will be
required. While anticipating
the need for blood is an
important step in that
resuscitation, other
interventions will be required.
To accomplish these
interventions expeditiously
and effectively, additional
trained hands will be required.
The sooner the call for help is
made the faster that help will
arrive.
6-6Q
You were asked “What should you
do next?”
6-5A
You correctly answered,
“Intubate with a 3.5 endotracheal
tube.” A patient in this condition
will require extensive
resuscitation. While a number of
important interventions will likely
need to be performed during the
course of the resuscitation, a
secure airway is paramount.
Successful intubation and skilled
ventilation will optimize lung
inflation, minimize the risk of
gastric distension and
subsequent impairment of
diaphragmatic excursion, and
provide a route for drug delivery.
You answered, “Ask the second
While epinephrine is indicated
draw up a dose of
epinephrine
nurse to draw up a dose of
epinephrine.” While epinephrine is
indicated for persistent bradycardia,
other interventions (including
establishing a route for drug
delivery) are of higher priority at this
point in the resuscitation.
for persistent bradycardia,
other interventions (including
establishing a route for drug
delivery) are of higher priority
at this point in the
resuscitation.
6-6Q
Catheterize the umbilical
vein
Quiz_option
You answered, “Catheterize the
umbilical vein.” Administration of
epinephrine and volume is likely
to be indicated in this situation
and emergent umbilical venous
catheterization is a quick way to
facilitate delivery of these agents.
However establishing a secure
airway is a higher priority at this
point in the resuscitation.
Administration of epinephrine
and volume is likely to be
indicated in this situation and
emergent umbilical venous
catheterization is a quick way
to facilitate delivery of these
agents. However establishing
a secure airway is a higher
priority at this point in the
resuscitation.
6-6Q
Place an oximeter
Quiz_option
You answered, “Place an oximeter.”
Placement of an oximeter is
indicated anytime that supplemental
oxygen/positive pressure ventilation
is to be delivered for more than a
few breaths. While this is certainly
true in this situation establishing a
secure airway is a higher priority at
this point in the resuscitation.
Placement of an oximeter is
indicated anytime that
supplemental oxygen/positive
pressure ventilation is to be
delivered for more than a few
breaths. While this is certainly
true in this situation
establishing a secure airway is
a higher priority at this point in
the resuscitation.
6-5A
6-6
6-5a.mov
6-6.mov
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6-6
6-7Q
You correctly answered, “turn on
the oximeter, attach the probe to
the newborn’s right wrist, plug
the probe into the oximeter.” The
most rapid acquisition of signal
is obtained when the probe is
placed on the patient prior to
being plugged into the oximeter.
The probe is placed on the right
wrist in order to sample blood
that is not mixed with
deoxygenated blood shunting
from right-to-left across the
ductus arteriosus (which may
remain patent for hours after
birth). This provides a more
accurate assessment of
pulmonary function.
You were asked: “At this point you
should:”
You answered, “Administer normal
saline via the UVC.” While
hypovolemia should be suspected
in a patient with this history and
presentation, it is important to
administer epinephrine immediately
upon achieving intravenous access
in this patient with persistent
bradycardia. A volume bolus
should also be prepared and follow
the epinephrine.
6-7Q
At this point you should:
Quiz_question
6-7Q
Administer normal saline
via the UVC
Quiz_option
6-7Q
Administer epinephrine via
the endotracheal tube
Quiz_option
You answered, “Administer
epinephrine via the endotracheal
tube.” The preferred route for
epinephrine is intravenous.
Epinephrine can be delivered via an
endotracheal tube while umbilical
access is being achieved as long as
doing so does not delay other
necessary interventions. The
efficacy of intratracheal epinephrine
is suboptimal compared with
intravenous dosing.
The preferred route for
epinephrine is intravenous.
Epinephrine can be delivered
via an endotracheal tube while
umbilical access is being
achieved as long as doing so
does not delay other
necessary interventions. The
efficacy of intratracheal
epinephrine is suboptimal
compared with intravenous
dosing.
6-7Q
Administer 5% albumin via
the UVC
Quiz_option
You answered, “Administer 5%
albumin via the UVC.” While
hypovolemia should be suspected
in a patient with this history and
presentation, it is reasonable to
administer epinephrine immediately
upon achieving intravenous access
in this patient with persistent
bradycardia. A volume bolus
should also be prepared and follow
the epinephrine.
While hypovolemia should be
suspected in a patient with this
history and presentation, it is
reasonable to administer
epinephrine immediately upon
achieving intravenous access
in this patient with persistent
bradycardia. A volume bolus
should also be prepared and
follow the epinephrine.
6-7Q
Administer epinephrine
via the UVC
Quiz_option_right
100
6-7A_Q
You correctly answered,
“Administer epinephrine via the
UVC.” While hypovolemia should
be suspected in a patient with
this history and presentation, it is
important to administer
epinephrine immediately upon
achieving intravenous access in
While hypovolemia should be
suspected in a patient with this
history and presentation, it is
important to administer
epinephrine immediately upon
achieving intravenous access
in this patient with persistent
bradycardia. A volume bolus
should also be prepared and
follow the epinephrine.
this patient with persistent
bradycardia. A volume bolus
should also be prepared and
follow the epinephrine.
You were asked, “At this point you
should administer:”
6-7A_Q
At this point you should
administer:
Quiz_question
6-7A_Q
Epinephrine 1:10,000, 0.3
ml via the UVC
Quiz_option_right
6-7A_Q
Epinephrine 1:1,000, 0.3 ml
via the UVC
Quiz_option
You answered, “Epinephrine
1:1,000, 0.3 ml via the UVC.” The
appropriate concentration of
epinephrine for use in the neonate
is 1:10,000. The appropriate
intravenous dose is 0.1-0.3 ml/kg or
0.01-0.03 mg/kg. It is reasonable to
assume a weight of 3 kg in this full
term neonate. A 0.3 ml dose of
epinephrine, 1:1,000 concentration,
is inappropriate.
The appropriate concentration
of epinephrine for use in the
neonate is 1:10,000. The
appropriate intravenous dose
is 0.1-0.3 ml/kg or 0.01-0.03
mg/kg. It is reasonable to
assume a weight of 3 kg in
this full term neonate. A 0.3
ml dose of epinephrine,
1:1,000 concentration, is
inappropriate.
6-7A_Q
Epinephrine 1:10,000, 3 ml
via the UVC
Quiz_option
You answered, “Epinephrine
1:10,000, 3 ml via the UVC.” The
appropriate concentration of
epinephrine for use in the neonate
is 1:10,000. The appropriate
intravenous dose is 0.1-0.3 ml/kg or
0.01-0.03 mg/kg. It is reasonable to
assume a weight of 3 kg in this full
term neonate. A 3 ml dose of
epinephrine, 1:10,000
concentration, is appropriate.
The appropriate concentration
of epinephrine for use in the
neonate is 1:10,000. The
appropriate intravenous dose
is 0.1-0.3 ml/kg or 0.01-0.03
mg/kg. It is reasonable to
assume a weight of 3 kg in
this full term neonate. A 3 ml
dose of epinephrine, 1:10,000
concentration, is appropriate.
6-7A_Q
Epinephrine 1:1,000, 3 ml
via the UVC
Quiz_option
You answered, “Epinephrine
1:1,000, 3 ml via the UVC.” The
appropriate concentration of
epinephrine for use in the neonate
is 1:10,000. The appropriate
intravenous dose is 0.1-0.3 ml/kg or
The appropriate concentration
of epinephrine for use in the
neonate is 1:10,000. The
appropriate intravenous dose
is 0.1-0.3 ml/kg or 0.01-0.03
mg/kg. It is reasonable to
100
6-7
You correctly answered,”
Epinephrine 1:10,000, 0.3 ml via
the UVC.” The appropriate
concentration of epinephrine for
use in the neonate is 1:10,000.
The appropriate intravenous
dose is 0.1-0.3 ml/kg or 0.01-0.03
mg/kg. It is reasonable to
assume a weight of 3 kg in this
full term neonate. A 0.3 ml dose
of epinephrine, 1:10,000
concentration, is appropriate.
0.01-0.03 mg/kg. It is reasonable to
assume a weight of 3 kg in this full
term neonate. A 3 ml dose of
epinephrine, 1:1,000 concentration,
is appropriate.
6-7
6-8
6-9Q
6-7.mov
6-8.mov
What should you do now?
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100
100
assume a weight of 3 kg in
this full term neonate. A 3 ml
dose of epinephrine, 1:1,000
concentration, is appropriate.
6-8
6-9Q
You were asked, ”What should you
do now?”
6-9Q
Administer normal saline
30 ml via the UVC
Quiz_option
You answered, “Administer normal
saline 30 ml via the UVC.” The
patient has a secure airway and a
heart rate above 100 beats per
minute. While additional normal
saline may produce further
improvement in the patient’s
perfusion, it is reasonable to
transport the patient to the nursery
where additional skilled
professionals capable of assisting in
the stabilization of this patient and
appropriate equipment and supplies
are readily available.
The patient has a secure
airway and a heart rate above
100 beats per minute. While
additional normal saline may
produce further improvement
in the patient’s perfusion, it is
reasonable to transport the
patient to the nursery where
additional skilled professionals
capable of assisting in the
stabilization of this patient and
appropriate equipment and
supplies are readily available.
6-9Q
Administer sodium
bicarbonate, 4.2%, via the
UVC
Quiz_option
You answered, “Administer sodium
bicarbonate, 4.2%, via the UVC.”
The patient has a secure airway
and a heart rate above 100 beats
per minute. It is reasonable to
transport the patient to the nursery
where additional skilled
professionals capable of assisting in
the stabilization of this patient and
appropriate equipment and supplies
are readily available. Sodium
bicarbonate should be used to treat
documented metabolic acidosis and
the dose guided by blood gas
and/or electrolyte analysis.
The patient has a secure
airway and a heart rate above
100 beats per minute. It is
reasonable to transport the
patient to the nursery where
additional skilled professionals
capable of assisting in the
stabilization of this patient and
appropriate equipment and
supplies are readily available.
Sodium bicarbonate should be
used to treat documented
metabolic acidosis and the
dose guided by blood gas
and/or electrolyte analysis.
6-9Q
Administer packed red cells
30 ml via the UVC
Quiz_option
You answered, “Administer packed
red cells 30 ml via the UVC.” The
patient has a secure airway and a
heart rate above 100 beats per
minute. While packed red blood
cells may produce further
improvement in the patient’s
perfusion, it is reasonable to
The patient has a secure
airway and a heart rate above
100 beats per minute. While
packed red blood cells may
produce further improvement
in the patient’s perfusion, it is
reasonable to transport the
patient to the nursery where
transport the patient to the nursery
where additional skilled
professionals capable of assisting in
the stabilization of this patient and
appropriate equipment and supplies
are readily available.
6-9Q
6-9
Transport the neonate to
the nursery
6-9.mov
Quiz_option_right
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6-9
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END
You answered, “Transport the
neonate to the nursery.” The
patient has a secure airway and a
heart rate above 100 beats per
minute. While additional normal
saline may produce further
improvement in the patient’s
perfusion, it is reasonable to
transport the patient to the
nursery where additional skilled
professionals capable of
assisting in the stabilization of
this patient and appropriate
equipment and supplies are
readily available.
additional skilled professionals
capable of assisting in the
stabilization of this patient and
appropriate equipment and
supplies are readily available.