Lightning Learning: Newborn Life Support
““Newborn Life Support (NLS) provides a framework for managing newborn infants who need support at time of birth.””
What?
Delivering an infant is rare in most emergency departments, Newborn Life Support (NLS) provides a framework for managing newborn infants who need support around the time of birth.
Get help from the neonatal resuscitation team, then...
Dry and warm the baby
Asses for tone, breathing and heart rate
Support breathing using air with 5 ventilations if required
Consider pre-ductal SpO2
If no improvement recheck ventilation
If HR <60 bpm, commence chest compressions at a rate of 3:1
Why?
During delivery, the fetus experiences hypoxia for about 60 seconds during contractions. A small number of infants will require help with ventilation on delivery. Pathological problems can also result in hypoxia.
If hypoxia continues the fetus goes through primary apnoea, reverting to anaerobic metabolism, which can impair cardiac function.
Ventilation is usually all that is required in most cases, sometimes with a period of chest compressions.
Drugs are rarely required and often associated with poor outcomes.
Further Reading
- Resus Council UK: Resuscitation and Support of Transition of Babies at Birth
- Resus Council UK: Newborn Life Support (video)
- UHL: Guideline for the Resuscitation of the Newborn Infant at Birth (local)
