Pengurus Pusat IDAI & UKK Neonatologi IDAI

berkolaborasi dengan
American Academy of Pediatrics (AAP)

Training of The Trainers neonatal Resuscitation

Jakarta, 9 - 11 Desember 2013

CHEST COMPRESSION DURING

RESUSCITATION OF THE NEWBORN INFANT
 INDICATIONS FOR STARTING CHEST
COMPRESSIONS:

HR < 60/minute despite adequate asisted ventilation with

supplementary O2 for 30 Seconds
 WHY PERFORM CHEST
COMPRESSIONS?
 Babies who have HR < 60/min, despite stimulation and 30 sec of
positive-pressure ventilation  very low blood oxygen levels.
 Myocardium is depressed, & unable to contract strongly enough to
pump blood to the lungs.
 Therefore, you will need to mechanically pump the heart while you
simultaneously continue to ventilate the lungs until the myocardium
becomes sufficiently oxygenated to recover adequate spontaneous
function.
 HOW MANY PEOPLE ARE NEEDED TO
ADMINISTER CHEST COMPRESSIONS, WHERE
SHOULD THEY STAND ?

Two people are required;

 One to compress the chest  must have access to the chest
and be able to position his or her hands correctly
 One to continue ventilation  need to be positioned at the
baby’s head
 Technique - chest compressions

“Two-Thumb” technique “two-finger” technique

3 compressions to 1 breath
 “Two –Thumb” technique

PREFERRED METHOD
Superimposed or
Advantages adjacent to each
Improving peak other
Fingers
systolic & coronary
surrounding the
perfusion pressure
thorax to support
without additional
the back
complication

Less tiring for

rescuer The size of the
Perceived as infant
easier
 “Two-finger” technique

More convenient if the baby is large or

your hands are small

Preferable to provide access to the

umbilicus when medications need to
be given by the umbilical route
 CHEST COMPRESSIONS

Location Depth Approximately

1/3 of the chest
The lower third of the Anterior-Posterior
sternum diameter.

Which lies between the

xyphoid and a line drawn
between the nipples.
Position - chest compressions

1/3rd

anterior - posterior diameter of the chest

 How often do you compress the chest &
coordinate with ventilation ?

 Ratio: 3 compressions to 1
breath (120 events/min with a
pause between the breath &
compression

‘One & two & three & breathe’

 Chest Compression Should be
performed
Compression
&Inflations should be
coordinated to avoid
simultaneous delivery Ratio 3 compression: 1 breath
of a compressions &
a breath

The rescuer’s hand 90 compression & 30

should not leave the
chest
breaths in each minute
 • Increased inspired O2 to
100%
Effectively • Pulsation evident on an
delivered chest oximeter
compressions
Once Chest Compressions Have been
commenced

Signs of
little interruption • Do not stop Improvement
as possible unless spontaneous CO :
(For at least 30 assessment is • A rise in O2 saturation
seconds between needed to make • Some spontaneous
movement /breaths
each pause) treatment
decisions
THANK YOU