ROP

Preparation for resuscitation of a preterm neonate

Preterm babies need extra preparation for resuscitation. All preterm deliveries must be attended by atleast 2 persons. Additional skilled people may be required if the resuscitation is prolonged or if there is twin delivery

In addition to regular resuscitation equipments preterms need following specific equipments. For thermal care, room temp should be kept at 25-28 C and in addition a plastic wrap be kept ready for very preterm babies. Suction catheters of size 8-10 F Gauge is required to suction when indicated, To support breathing, Preterm self inflating bag (180-250 ml), preterm face mask, oxygen blender, T piece resuscitator, pulseoximeter is necessary. A laryngoscope with size 0 and 00 blade with ET size of 2.5 should be immediately available. An equipment checklist in the delivery room helps to ensure all equipments are present and in working condition.

Thermal support is an essential component for preterm care in delivery room. Hypothermia is common and is a know predictor of poor outcomes in preterm babies. All efforts must be made before and during resuscitation to ensure normothermia. Prior to arrival of the baby, the room should be warm, the warmer turned on with clean dry sheets kept under the warmer to ensure a warm welcome. All preterm babies needing resuscitation are kept under warmer in servo mode with a set temp of 36 C For very preterm babies, immediately after birth before drying a plastic wrap is applied. The target is to maintain temp between 36.5-37.5 C

Preparation also includes preparation of parents to meet the challanges of preterm care. This starts prior to arrival of the baby. Parents need to be told about anticipated problems and the treatment options available in simple clear language, The information should be based on unit practices and outcome and should be realistic about chances of survival.