Basic techniques in resuscitation
The birth of a new child is usually a joyous occasion. However, the newborn infant may ocassionally be compromised and need our help. The Apgar score is a tool used to evaluate the newborn during the first few minutes after birth, and you should familiarize yourself with that tool and know how to use and interpret it. (In the chapter which covers the newborn period you will find a link to an interactive tool which allows you to practice using the Apgar scoring system.) As a simple rule of thumb - when the Apgar score is 8 or more, the infant is OK and can (with rare exceptions) be expected to do well. If the Apgar score is 4-7, the infant needs to be watched carefully, and may go on to need interventions on our part. When the Apgar score i 0-3, the infant needs immediate assistance. The purpose of these videos is to teach you the basic techniques involved in resuscitation of a newborn infant. You should watch the videos in sequence. They will show you how to apply and hold a mask to the infant's face, how the resuscitation bag works and is used, and how to perform chest compressions. (Please remember that "chest compression" is to some extent a misnomer - it is the heart that you really aim to compress.) You need to practice and master these basic skills first. The next step is then to practice the team work which is always involved in resuscitation. The videos which you will find here do not cover the team process. However, elsewhere in this chapter you will find a link to an online video from Haukeland University Hospital in Bergen, Norway, and which shows the whole process (in Norwegian only). For those of you who do not speak Norwegian, there are English-language teaching resources available from the American Academy of Pediatrics (http://www.aap.org). For Norwegian-speaking users, the web-site of the Norwegian Resuscitation Council (http://www.nrr.org/) contains a number of useful resources, including wall charts with "decision trees".
Credits The video clips you will find here have been abstracted from a 21 min video entitled 'Examination of the newborn', which was produced for the 'Skills Center' (Ferdighetssenteret) by the University of Oslo Photo and Video Service in 2003. This video, which is available on loan from the Skills Center for medical students at The University of Oslo, was the result of a term project by medical students Robert Bentehaugen and Anders Lippert. Filming was done by Christian Nissen and Bjorn Ohnstad, and editing was by Christian Nissen, Robert Bentehaugen, and Anders Lippert. The pediatrician/neonatologist, professor Thor Willy Ruud Hansen, has also written the text which accompanies the clips.