Beruflich Dokumente
Kultur Dokumente
Neonatal
EDITOR
Gary M. Weiner, MD, FAAP
ASSOCIATE EDITOR
Jeanette Zaichkin, RN, MN, NNP-BC
EDITOR EMERITUS
Resuscitation
John Kattwinkel, MD, FAAP
For nearly 30 years, the Neonatal Resuscitation Program (NRP) has helped health care providers
acquire the knowledge and skills to perform neonatal resuscitation.
Now in its 7th edition, the NRP uses a blended learning approach, which includes online testing,
online case-based simulations, and hands-on case-based simulation/debriefing that focus on critical
leadership, communication, and teamwork skills.
Content updates throughout the text reflect the 2015 American Academy of Pediatrics (AAP)/
American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency 7th Edition
Cardiovascular Care of the Neonate. Must-know new material includes the latest recommendations
across key areas of change, including
Timing of umbilical cord clamping
Concentration of oxygen during resuscitation
Use of continuous positive airway pressure (CPAP) during and after resuscitation
Management of meconium-stained amniotic fluid
Electronic cardiac (ECG) monitoring during resuscitation
Estimation of endotracheal tube insertion depth
Methods of thermoregulation for preterm newborns
The extensively revised and updated textbook also includes several new features to enhance
learning.
Focus on Teamwork: Examples of how the NRP Key Behavioral Skills are used in context with
thelesson content.
Frequently Asked Questions: Several FAQs regarding lesson content that may spark questions
fromlearners.
Ethical Considerations: Ethical questions to consider in context of the lesson content.
Additional Reading: The editors choice of journal articles related to the lesson content.
The Textbook of Neonatal Resuscitation, 7th edition, and related products can be purchased
directly from the AAP at shop.aap.org.
AAP
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Textbook of Neonatal
Resuscitation, 7th Edition
Editor
Gary M. Weiner, MD, FAAP
Associate Editor
Jeanette Zaichkin, RN, MN, NNP-BC
Editor Emeritus
John Kattwinkel, MD, FAAP
The recommendations in this publication and the accompanying materials do not indicate an exclusive course of treatment or
serve as a standard of care. Variations, taking into account individual circumstances, nature of medical oversight, and local
protocols, may be appropriate.
Every effort has been made to ensure that contributors to the Neonatal Resuscitation Program materials are knowledgeable
authorities in their fields. Readers are nonetheless advised that the statements and opinions expressed are provided as guidelines
and should not be construed as official policy of the American Academy of Pediatrics or the American Heart Association.
This material is made available as part of the professional education programs of the American Academy of Pediatrics and the
American Heart Association. No endorsement of any product or service should be inferred or is intended.
The American Academy of Pediatrics and the American Heart Association disclaim any liability or responsibility for the
consequences of any actions taken in reliance on these statements or opinions.
The American Academy of Pediatrics reserves the right to disclose personal information related to course completion of course
participants/providers for administrative purposes such as to verify participation or classes taken or to validate the status of any
Course Completion Card. In no event shall the American Academy of Pediatrics or American Heart Association have any liability for
disclosure or use of information for such purposes or responsibility for the consequences of any actions taken in reliance on such
information.
All rights reserved. No part of this publication or its accompanying materials may be reproduced, stored in a retrieval system, or
transmitted in any form or by any meanselectronic, mechanical, photocopying, recording, or otherwisewithout prior permission
from the publisher (locate title at http://ebooks.aappublications.org and click on Get Permissions; you may also fax the
permissions editor at 847/434-8780 or e-mail permissions@aap.org). First edition published 1987; second, 1990; third, 1994;
fourth, 2000; fifth, 2006; sixth, 2011.
NRP323
ISBN: 978-1-61002-024-4
eBook: 978-1-61002-025-1
5-276/0416
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Liaison Representatives
Eric C. Eichenwald, MD, FAAP Linda McCarney, MSN, APRN, NNP-BC
AAP Committee on Fetus and Newborn National Association of Neonatal Nurses
John Gallagher, MPH, RRT-NPS Patrick McNamara, MB, FRCPC
American Association for Respiratory Care Canadian Paediatric Society
Jessica Illuzzi, MD, MS, FACOG
American College of Obstetricians
and Gynecologists
Associated Education Materials for the Textbook of Neonatal Resuscitation, 7th Edition
Instructor Toolkit, Jeanette Zaichkin, RN, MN, NRP Key Behavioral Skills Poster, Louis P. Halamek,
NNP-BC, Editor MD, FAAP, Editor
Instructor Course, Jeanette Zaichkin, RN, MN, NRP Equipment Poster, Jeanette Zaichkin, RN, MN,
NNP-BC, Editor; Vishal Kapadia, MD, MSCS, FAAP; NNP-BC, Editor
Henry C. Lee, MD, FAAP; Taylor Sawyer, DO, MEd, NRP App, Steven Ringer, MD, PhD, FAAP and
FAAP; and Nicole K. Yamada, MD, FAAP, Marya L. Strand, MD, MS, FAAP, Editors
Contributors
Neonatal Resuscitation Scenarios, Jeanette Zaichkin,
NRP Online Examination for Instructors, Jeanetet RN, MN, NNP-BC, Editor; Myra H. Wyckoff, MD,
Zaichkin, RN, MN, NNP-BC FAAP; Vishal Kapadia, MD, MSCS, FAAP; Marya L.
NRP Online Examination for Providers, Steven Ringer, Strand, MD, MS, FAAP, Contributors
MD, PhD, FAAP, and Jerry Short, PhD, Editors
NRP Reference Chart, Code Cart Cards, and Pocket
Cards, Vishal Kapadia, MD, MSCS, FAAP, Editor
The committee would like to express thanks to the following reviewers and contributors
to this textbook:
American Academy of Pediatrics Committee on Fetus Errol R. Alden, MD, FAAP, AAP Board-appointed
and Newborn Reviewer
American Academy of Pediatrics Section on Bioethics Steven M. Schexnayder, MD, FAAP, AHA-appointed
International Liaison Committee on Resuscitation, Reviewer
Neonatal Delegation Aviva L. Katz, MD, FAAP, AAP Committee on Bioethics
Jeffrey M. Perlman, MB, ChB, FAAP, Co-chair Reviewer
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Appendix:
Part 13: Neonatal Resuscitation 2015 American Heart Association Guidelines
Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care (Reprint) 277
Index 305
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Level of Responsibility
The NRP Provider Course consists of 11 lessons, and participants
are required to complete all 11 lessons to receive an NRP Course
Completion Card. Even though not all newborn health care providers
can perform all steps in resuscitation, they may be called to help a team
and need to be familiar with each step.
Special Note: Neonatal resuscitation is most effective when performed
by a designated and coordinated team. It is important for you to know
the neonatal resuscitation responsibilities of team members who are
working with you. Periodic practice among team members will
facilitate coordinated and effective care of the newborn.
NRP eSim
NRP eSim is a new online neonatal resuscitation simulation exercise
required for achieving NRP provider status with the 7th edition. The
eSim methodology allows learners to integrate the NRP flow diagram
steps in a virtual environment. For additional information on eSim,
including Web browser requirements, visit www.aap.org/nrp.
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Lesson Completion
Successful completion of the online examination and eSim cases is
required before learners attend the skills/simulation portion of the
NRP course. Learners must attend the skills/simulation portion of the
course within 90 days of completing the online examination and eSim
cases. To successfully complete the course, participants must pass the
online examination, complete eSim cases, demonstrate mastery of
resuscitation skills in the Integrated Skills Station, and participate in
simulated resuscitation scenarios, as determined by the course
instructor(s).
Upon successful completion of these requirements, participants are
eligible to receive a Course Completion Card. Following the skills/
simulation portion of the course, learners will receive an e-mail with a
link to complete an online course evaluation. Once the online course
evaluation is completed, an electronic Course Completion Card will be
available in the learners NRP Database profile.
Standard Precautions
The US Centers for Disease Control and Prevention has recommended
that standard precautions be taken whenever risk of exposure to blood
or bodily fluids is high and the potential infection status of the patient
is unknown, as is certainly the case in neonatal resuscitation.
All fluid products from patients (blood, urine, stool, saliva, vomitus, etc)
should be treated as potentially infectious. Gloves should be worn when
resuscitating a newborn, and the rescuer should not use his or her mouth
to apply suction via a suction device. Mouth-to-mouth resuscitation
should be avoided by having a resuscitation bag and mask or T-piece
resuscitator always available for use during resuscitation. Masks and
protective eyewear or face shields should be worn during procedures
that are likely to generate droplets of blood or other bodily fluids.
Gowns or aprons should be worn during procedures that probably will
generate splashes of blood or other bodily fluids. Delivery rooms must
be equipped with resuscitation bags, masks, laryngoscopes, endotracheal
tubes, mechanical suction devices, and the necessary protective shields.
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by AAP, 2016. All rights reserved.