Neonatal Resuscitation – Circulation and Drugs
Consider drugs (k) if heart rate beats/min in spite of adequate ventilation and chest compression, though evidence for their efficacy is lacking
Rarely needed.
Drugs should be given via an umbilical venous catheter, or, if not possible, via an intra-osseous needle.
Drugs given via a peripheral vein are unlikely to reach the heart. Giving standard doses of epinephrine (adrenaline) down the endotracheal tube does not appear to be effective, so drug dosage is increased for this route.
A newborn baby who looks white and has poor skin and peripheral perfusion due to acidosis and peripheral vasoconstriction may have had acute blood loss. There may be a history of antepartum haemorrhage or acute twin-to-twin transfusion.
Immediate blood transfusion with Group O rhesus negative blood is required.
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