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October 28, 1992, Vol 268, No. 16 >
ARTICLE | October 28, 1992

Neonatal Resuscitation FREE

JAMA. 1992;268(16):2276-2281. doi:10.1001/jama.1992.03490160146030
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APPROXIMATELY 3.5 million babies are born each year in about 5000 hospitals in the United States, only 15% of which have neonatal intensive care facilities. Six percent of all newborns require life support in the delivery room or nursery, and among newborns who weigh less than 1500 g at birth, the need for resuscitation rises dramatically. It is essential that the knowledge and skills required for neonatal resuscitation be taught to delivery room personnel in every institution. Each hospital should develop a protocol for implementing such a program.

Personnel skilled in neonatal resuscitation and capable of functioning as a team must be available to an appropriately equipped delivery room. At least one person skilled in neonatal resuscitation should attend every delivery. An additional skilled person should be readily available because resuscitation of a severely depressed newborn requires at least two people, one to ventilate and, if necessary, intubate and the

REFERENCES

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Adamsons K Jr, Gandy GM, James LS.  The influence of thermal factors upon oxygen consumption of the newborn human infant. J Pediatr . 1965;;66:495-508.
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Cordero L Jr, Hon EH.  Neonatal bradycardia following nasopharyngeal stimulation. J Pediatr . 1971;;78:441-447.
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David R.  Closed chest cardiac massage in the newborn infant. Pediatrics . 1988;;81:552-554.
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Berkowitz ID, Gervais H, Schleien CL, Koehler RC, Dean JM, Traystman RJ.  Epinephrine dosage effects on cerebral and myocardial blood flow in an infant swine model of cardiopulmonary resuscitation. Anesthesiology . 1991;; 75:1041-1050.
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Goetting MG, Paradis NA.  High-dose epinephrine improves outcome from pediatrie cardiac arrest. Ann Emerg Med . 1991;;20:22-26.
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Barton C, Callaham M.  High-dose epinephrine improves the return of spontaneous circulation rates in human victims of cardiac arrest. Ann Emerg Med . 1991;;20:722-725.
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Paradis NA, Martin GB, Rosenberg J, et al.  The effect of standard- and high-dose epinephrine on coronary perfusion pressure during prolonged cardiopulmonary resuscitation. JAMA . 1991;;265:1139-1144.
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Orlowski JP, Gallagher JM, Porembka DT.  Endotracheal epinephrine is unreliable. Resuscitation . 1990;;19:103-113.
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Quinton DN, O'Byrne G, Aitkenhead AR.  Comparison of endotracheal and peripheral intravenous adrenaline in cardiac arrest: is the endotracheal route reliable? Lancet . 1987;;1:828-829.
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Ralston SH, Tacker WA, Showen L, Carter A, Babbs CF.  Endotracheal versus intravenous epinephrine during electromechanical dissociation with CPR in dogs. Ann Emerg Med . 1985;;14:1044-1048.
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Handal KA, Schauben JL, Salamone FR.  Naloxone. Ann Emerg Med . 1983;;12:438-445.
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Clark RB, Beard AG, Barclay DL.  Naloxone in the newborn infant. Anesth Rev . 1975;;2:9-19,75.
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Evans JM, Hogg MIJ, Rosen M.  Reversal of narcotic depression in the neonate by naloxone. BMJ . 1976;;2:1098-1100.
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American Academy of Pediatrics Committee on Drugs.  Emergency drug doses for infants and children and naloxone use in newborns: clarification. Pediatrics . 1989;;83:803.
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Ostrea EM Jr, Odell GB.  The influence of bicarbonate administration on blood pH in a 'closed system': clinical implications. J Pediatr . 1972;;80: 671-680.
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Simmons MA, Adcock EW III, Bard H, Battaglia FC.  Hypernatremia and intracranial hemorrhage in neonates. N Engl J Med . 1974;;291:6-10.
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Finberg L.  The relationship of intravenous infusions and intracranial hemorrhage: a commentary. J Pediatr . 1977;;91:777-778.
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Papile LA, Burstein J, Burstein R, Koffler H, Koops B.  Relationship of intravenous sodium bicarbonate infusions and cerebral intraventricular hemorrhage. J Pediatr . 1978;;93:834-836.
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Graf H, Leach W, Arieff AI.  Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis. Science . 1985;;227:754-756.
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Greenberg MI, Roberts JR, Baskin SI, Wagner DK.  The use of endotracheal medication for cardiac arrest. Top Emerg Med . 1979;;1:29-40.
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Ward JT Jr.  Endotracheal drug therapy. Am J Emerg Med . 1983;;1:71-82.
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Wiswell TE, Tuggle JM, Turner BS.  Meconium aspiration syndrome: have we made a difference? Pediatrics . 1990;;85:715-721.
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Rossi EM, Philipson EH, Williams TG, Kalhan SC.  Meconium aspiration syndrome: intrapartum and neonatal attributes. Am J Obstet Gynecol . 1989;; 161:1106-1110.
27 +
Carson BS, Losey RW, Bowes WA Jr, Simmons MA.  Combined obstetric and pediatrie approach to prevent meconium aspiration syndrome. Am J Obstet Gynecol . 1976;;126:712-715.
28 +
Falciglia HS.  Failure to prevent meconium aspiration syndrome. Obstet Gynecol . 1988;;71:349-353.
29 +
Locus P, Yeomans E, Crosby U.  Efficacy of bulb versus DeLee suction at deliveries complicated by meconium stained amniotic fluid. Am J Perinatal . 1990;;7:87-91.
30 +
MacDonald HM, Mulligan JC, Allen AC, Taylor PM.  Neonatal asphyxia, I: relationship of obstetric and neonatal complications to neonatal mortality in 38405 consecutive deliveries. J Pediatr . 1980;;96:898-902.
31 +
Hambleton G, Wigglesworth JS.  Origin of intraventricular haemorrhage in the preterm infant. Arch Dis Child . 1976;;51:651-659.
32 +
Day RL, Caliguiri L, Kamenski C, et al.  Body temperature and survival of premature infants. Pediatrics . 1964;;34:171-181.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Scopes JW, Ahmed I.  Range of critical temperatures in sick and premature newborn babies. Arch Dis Child . 1966;;41:417-419.
2 +
Adamsons K Jr, Gandy GM, James LS.  The influence of thermal factors upon oxygen consumption of the newborn human infant. J Pediatr . 1965;;66:495-508.
3 +
Cordero L Jr, Hon EH.  Neonatal bradycardia following nasopharyngeal stimulation. J Pediatr . 1971;;78:441-447.
4 +
Todres ID, Rogers MC.  Methods of external cardiac massage in the newborn infant. J Pediatr . 1975;;86:781-782.
5 +
David R.  Closed chest cardiac massage in the newborn infant. Pediatrics . 1988;;81:552-554.
6 +
Zaritsky A, Chernow B.  Use of catecholamines in pediatrics. J Pediatr . 1984;;105:341-350.
7 +
Berkowitz ID, Gervais H, Schleien CL, Koehler RC, Dean JM, Traystman RJ.  Epinephrine dosage effects on cerebral and myocardial blood flow in an infant swine model of cardiopulmonary resuscitation. Anesthesiology . 1991;; 75:1041-1050.
8 +
Goetting MG, Paradis NA.  High-dose epinephrine improves outcome from pediatrie cardiac arrest. Ann Emerg Med . 1991;;20:22-26.
9 +
Barton C, Callaham M.  High-dose epinephrine improves the return of spontaneous circulation rates in human victims of cardiac arrest. Ann Emerg Med . 1991;;20:722-725.
10 +
Paradis NA, Martin GB, Rosenberg J, et al.  The effect of standard- and high-dose epinephrine on coronary perfusion pressure during prolonged cardiopulmonary resuscitation. JAMA . 1991;;265:1139-1144.
11 +
Orlowski JP, Gallagher JM, Porembka DT.  Endotracheal epinephrine is unreliable. Resuscitation . 1990;;19:103-113.
12 +
Quinton DN, O'Byrne G, Aitkenhead AR.  Comparison of endotracheal and peripheral intravenous adrenaline in cardiac arrest: is the endotracheal route reliable? Lancet . 1987;;1:828-829.
13 +
Ralston SH, Tacker WA, Showen L, Carter A, Babbs CF.  Endotracheal versus intravenous epinephrine during electromechanical dissociation with CPR in dogs. Ann Emerg Med . 1985;;14:1044-1048.
14 +
Handal KA, Schauben JL, Salamone FR.  Naloxone. Ann Emerg Med . 1983;;12:438-445.
15 +
Clark RB, Beard AG, Barclay DL.  Naloxone in the newborn infant. Anesth Rev . 1975;;2:9-19,75.
16 +
Evans JM, Hogg MIJ, Rosen M.  Reversal of narcotic depression in the neonate by naloxone. BMJ . 1976;;2:1098-1100.
17 +
American Academy of Pediatrics Committee on Drugs.  Emergency drug doses for infants and children and naloxone use in newborns: clarification. Pediatrics . 1989;;83:803.
18 +
Ostrea EM Jr, Odell GB.  The influence of bicarbonate administration on blood pH in a 'closed system': clinical implications. J Pediatr . 1972;;80: 671-680.
19 +
Simmons MA, Adcock EW III, Bard H, Battaglia FC.  Hypernatremia and intracranial hemorrhage in neonates. N Engl J Med . 1974;;291:6-10.
20 +
Finberg L.  The relationship of intravenous infusions and intracranial hemorrhage: a commentary. J Pediatr . 1977;;91:777-778.
21 +
Papile LA, Burstein J, Burstein R, Koffler H, Koops B.  Relationship of intravenous sodium bicarbonate infusions and cerebral intraventricular hemorrhage. J Pediatr . 1978;;93:834-836.
22 +
Graf H, Leach W, Arieff AI.  Evidence for a detrimental effect of bicarbonate therapy in hypoxic lactic acidosis. Science . 1985;;227:754-756.
23 +
Greenberg MI, Roberts JR, Baskin SI, Wagner DK.  The use of endotracheal medication for cardiac arrest. Top Emerg Med . 1979;;1:29-40.
24 +
Ward JT Jr.  Endotracheal drug therapy. Am J Emerg Med . 1983;;1:71-82.
25 +
Wiswell TE, Tuggle JM, Turner BS.  Meconium aspiration syndrome: have we made a difference? Pediatrics . 1990;;85:715-721.
26 +
Rossi EM, Philipson EH, Williams TG, Kalhan SC.  Meconium aspiration syndrome: intrapartum and neonatal attributes. Am J Obstet Gynecol . 1989;; 161:1106-1110.
27 +
Carson BS, Losey RW, Bowes WA Jr, Simmons MA.  Combined obstetric and pediatrie approach to prevent meconium aspiration syndrome. Am J Obstet Gynecol . 1976;;126:712-715.
28 +
Falciglia HS.  Failure to prevent meconium aspiration syndrome. Obstet Gynecol . 1988;;71:349-353.
29 +
Locus P, Yeomans E, Crosby U.  Efficacy of bulb versus DeLee suction at deliveries complicated by meconium stained amniotic fluid. Am J Perinatal . 1990;;7:87-91.
30 +
MacDonald HM, Mulligan JC, Allen AC, Taylor PM.  Neonatal asphyxia, I: relationship of obstetric and neonatal complications to neonatal mortality in 38405 consecutive deliveries. J Pediatr . 1980;;96:898-902.
31 +
Hambleton G, Wigglesworth JS.  Origin of intraventricular haemorrhage in the preterm infant. Arch Dis Child . 1976;;51:651-659.
32 +
Day RL, Caliguiri L, Kamenski C, et al.  Body temperature and survival of premature infants. Pediatrics . 1964;;34:171-181.

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