SWINE FLU--TIPS FOR PREVENTION:
-----------------------------------------
1)Steam inhalation,after exposure.
2)Inhalation -2 hrly-four times daily.
3)Instantaneous relief of nasal irritation, post nasal drip,naso pharingeal irritability,internal ear-pain,irritability,blood stained mucus on spitting can be felt.But death of virus can not be expected in a day.symptoms persist till inflamation subsides.
4)continuous steam inhalation necessary for a week..
5)can offer better protection than vaccine
WHAT IS AN EXPOSURE?
---------------------------
1) An absolutely normal person developing sneezing ,throat,tosil,or nasopharyngeal pain after
entering into a crowded place or staying in an ac car with closed windows ,when one of the passenger is coughing or sneezing.symptoms start in2-6 hrs.
2)A suspected, infected person sneezes coughs in side a public escalater/lift
3)visiting a big shop,when floor is broomed.people with dust allergy,visiting such places.
4)hospital workers should protect with mask.
All this can not be proven as no scientific study was done.bUT ALL THE ABOVE ARE THEORITICALLY ACCEPTABLE,as viruses can no longer survive in steam exposure repeatedly.
THE PROOF OF THE PUDDING IS IN THE EATING.
Sunday, October 3, 2010
Saturday, August 28, 2010
NEW BORN BABY INTELLIGENCE-ALL ABOUT IT
INTRODUCTION:
A NEW BORN BAY' INTELLIGENCE DEPENDS UPON ITS INHERENT ABILITIES,&MANY OTHER EXTERNAL INFLUENCING FACTORS..ANY OR MANY OF THE FOLLOWING FACTORS MAY INTERFERE WITH THE THE BRAIN DEVELOPMENT &ITS INTELLIGENCE.
1)GENETIC MAKE UP
2)GOOD APGAR SCORE AT BIRTH.
3)INTRACRANIAL HEMORRHAGE.
4)CORD AROUND THE NECK PRIOR TO DELIVERY.
5)FETAL DISTRESS.
6)GOOD HEAD CIRCUMFERENCE AT BIRTH.
7)NO MATERNAL ANEMIA/HYPERTENSION/ MALNUTRITION.
8)GOOD VISION AT BIRTH.
9)GOOD HEARING CAPABILITY AT BIRTH.
10)EXTREMELY GOOD CRY AT BIRTH
(OPENS THE PATENCY OF ALL BRAIN BLOOD VESSELS)
11)GOOD THYROID STATUS (EU THYROID) IN MOTHER &BABY.
12)ENVIRONMENTAL STIMULATION-A CONTINUOUS PROCESS.
G E NE T I C M A K E U P
---------------------------
GENES ARE ULTRA(ELECTRON )MICROSCOPIC STRUCTURES.WHICH CARRY &PROPAGATE THE INTELLECTUAL CAPABILITY,OF ONE GENERATION TO ANOTHER GENERATION ALONG WITH MANY OTHER QUALITIES GOOD OR BAD ABOUT THE INDIVIDUALS CONCERNED.EDUCATION &INTELLIGENCE ARE NOT THE SAME .
AN EDUCATED PERSON NEED NOT BE INTELLIGENT&VICE VERSA.BUT EDUCATION DOES INCREASE THE INTELLECTUAL LEVEL.MANY UNEDUCATED MAY BE MORE INTELLIGENT THAN THE EDUCATED SO THE INTELLECTUAL TRAIT IS CARRIED FROM ONE GENERATION TO ANOTHER &OFTEN REFLECTED IN A CUMULATIVE MANNER,THROUGH THE GENES,CARRYING
TO POSITIVE PRINT IN THE NEXT GENERATION.TECHNICALLY THEY ARE REFERRED AS RNA,&DNA.THE FIRST GENERATION INDIVIDUAL MAY BE INTELLIGENT IN ONE WALK OF LIFE THE SECOND GENERATION COULD BE INTELLIGENT IN ANOTHER FIELD.THE THIRD GENERATION WILL HAVE INTELLIGENCE OF ITS OWN PLUS THE PREVIOUS TWO GENERATIONS INTELLIGENCE.THIS IS HOW THE INTELLIGENCE TREE KEEPS GROWING.
G O O D A P GA R S C O R E A T B I R T H.
----------------------------------------------
THIS MEANS THE CRY, COLOUR, ACTIVITY,REFLEXES,HEART RATE RESPIRATORY RATE ARE NORMAL WITHIN 10 Mts OF BIRTH&THAT THERE IS NO ASPHYXIA WHICH MEANS1)THE BRAIN BLOOD VESSELS ARE NOT PATENT ,OR NOT FULLY OPEN ,2)THERE IS NO ENOUGH OXYGEN SUPPLY TO THE BRAIN CELLS,3)THERE IS POOR GAS EXCHANGE IN THE LUNGS,WHICH MIGHT NOT HAVE EXPANDED FULLY.ULTIMATELY O2 SUPPLY TO BRAIN DECIDES THE NUMBER OF NEURONAL CELLS TO BE ACTIVE OR INACTIVE THE INACTIVE CELLS IF NOT PROPERLY OXYGENATED WITHIN 10-20 Mts WILL DIE & BECOME A SCAR THAT WILL LEAD ON TO THE DEVELOPMENT OF A CEREBRAL PALSY,LEADING TO MENTAL RETARDATION.
CEREBRAL PALSY MEANS ,PARALYSIS, OR MALFUNCTION,&PARTIAL OR TOTAL LOSS OF FUNCTION OF NEURONS AT CEREBRUM TO LACK OF BLOOD SUPPLY LEADING TO INSUFFICIENT OXYGEN ,TO NEURONS LEADING TO AN ALTERATION OF MUSCLE TONE&LOSS OF INTELLECTUAL FUNCTION LEADING TO,MENTAL RETARDATION OF VARIABLE DEGREES FROM POOR ACADEMIC PERFORMANCE TO TOTAL IDIOCY,OFTEN WITH INCREASED SPASTICITY OF ALL MUSCLES(ALSO KNOWN AS LITTLE'S DISEASE)(LITTLE WAS AN OUTSTANDING ORTHOPEDIC SURGEON IN THE WHOLE OF EUROPE WHO DISCOVERED THAT CEREBRAL PALSY IS DUE TO ASPHYXIA NEONATORUM &NOT PRIMARILY AN ORTHO CONDITION--THANKS TO DR LITTLE WHOSE OBSERVATION WAS BETTER THAN AN OBSTETRICIAN OF YESTER YEARS.
INTRA CRANIAL HAEMORRHAGE:
MANY NEW BORN BABIES SUFFER FROM THIS DISORDER, MAINLY DUE TOA A DEFICIENCY IN THE COAGULATION MECHANISM(FACTOR DEFICIENCY),AND THIS IS DUE TO A GENETIC DISORDER.THE HEMORRHAGE AGAIN IS VARIABLE AS PER THE QUANTITY OF THE DEFECT.INTRAVENTRICULAR HEMORRHAGE IS THE SEVEREST OF ALL,PRODUCING VERY MANY CNS COMPLICATIONS,SUCH AS FITS,SPASTICITY OF MUSCLES ,PARALYSIS,INTELLECTUAL DEFECT OF VARIABLE DEGREES.
FETAL DISTRESS:
OCCURS DURING ANTIPARTUM OR AT INTRAPARTUM PERIOD.SEVERE FETAL DISTRESS LEADS TO RESPIRATORY OR METABOLIC ACIDOSIS.CAN OCCUR IN THE FOLLOWING CONDITIONS:
1)INTRUTERINE GROWTH RETARDATION.
2)POST DATED GESTATION.
3)MATERNAL DIABETES MELLITUS
4)RHESUS SENSITISED PREGNANCY.
5)PREVIOUS H/O OF STILL BIRTH.
6)MATERNAL HYPERTENSION
7)FETAL HYPOXIA.
8)MATERNAL FEVER.
9)MATERNAL HYPERTHYROIDISM
10)FETAL ANEMIA, ARRHYTHMIA
11)PLACENTAL TRANSFER OF DRUGS
12)SLEEP STATE
13)PREMATURITY.
ALL THE ABOVE LEAD TO LESS BLOOD SUPPLY TO BRAIN RESULTING IN LESS OXYGEN SUPPLY TO CEREBRAL NEURONS THAT CAN JEOPARDISE THE INTELLECTUAL DEVELOPMENT
GOOD HEAD CIRCUMFERENCE AT BIRTH
---------------------------------------------
A BABY SHOULD HAVE AT LEAST 35 CM OF HEAD CIRCUMFERENCE.AT BIRTH.
1-2 CM LESS OR MORE ,MAY BE CONSIDERED AS VARIATIONS.ANYTHING LESSER MAY MEAN MICROCEPHALY &ANYTHING MORE MAY MEAN HYDROCEPHALUS, & NEEDS SERIAL MEASUREMENT FOR ASSESSMENT.&BOTH WILL AFFECT THE INTELLIGENCE GROSSLY.IN MICROCEPHALY IT IS NON DEVELOPEMENT,&IN HYDROCEPHALUS IT IS NEURONAL CELL DESTRUCTION BY THE SURROUNDING CSF PRESSURE THUS THE INTELLIGENCE DEVELOPMENT IS AFFECTED EVEN AT FOUNDATION LEVEL OF THE FUTURE CONSTRUCTION.
MATERNAL ANAEMIA/HYPERTENSION'S/MALNUTRITION.
MATERNAL ANAEMIA WILL LEAD TO FETAL ANAEMIA RESULTING IN POOR DELIVERY OF OXYGEN TO DEVELOPING NEURONAL CELLS THROUGH HEMOGLOBIN.AN ANOXIC CELL IS A WEEK CELL.HYPERTENSION WILL LEAD TO EXESS BLOOD FLOW&HEMORRHAGIC TENDENCY RESULTING IN CELL DEATH. MALNUTRITION WILL AFFECT CELL ANABOLISM AS PROTIEN IS NECESSARY FOR CONSTRUCTION&CARBOHYDRATE FOR FUEL.ALL THESE CONTRIBUTE FOR A POOR QUALITY NEURONAL CELL GROWTH &DEVELOPMENT OF INTELLIGENCE IS VERY DIFFICULT IN SUCH A DAMAGED CELL.
GOOD VISION AT BIRTH.
----------------------------
EYE IS SAID TO BE THE WINDOW OF THE BRAIN.MOST OF THE INFORMATION ENTERS INTO THE BRAIN VISUALLY&IS STORED LIKE A COMPUTER CHIP.INTELLIGENCE IS NOTHING BUT A COLLECTION OF INFORMATION,STORED, &RE UTILISATION OF THESE INFORMATION WHEN NECESSARY. OF THE NATURES FIVE GIFTED SPECIAL SENSES ,VISION IS BY FOR THE BEST.CHILDREN ARE GIVEN AUDIO VISUAL STIMULI TO IMPROVE THE INTELLECTUAL CAPACITY,DURING THEIR ATTEMPT TO LEARN.VARIOUS CONGENITAL EYE DEFECT MAY CONTRIBUTE DEFECTIVE VISION,LEADING TO INTERFERENCE WITH INTELLIGENCE FORMATION Eg :CONGENITAL CATARACT IN RUBELLA SYNDROME.
GOOD HEARING CAPABILITY :
WHEN DOES A NEWBORN START HEARING? WHEN CAN IT START SEEING?
BOTH ARE PRESENT AT BIRTH.IN FACT CAN HEAR &APPRECIATE SOUND WHEN IT IS IN UTERO WHEN A PREGNANT MOTHER SINGS THE BABY IS SUBJECTED TO THE VIBRATION TRANSMITTED THROUGH THE AMNIOTIC FLUID&THUS GETS USED TO SOUND APPRECIATION,UNLESS THERE IS A NEUROLOGICAL DEFICIT,OR A HYPOTHYROID STATE, AS SOON AS THE BABY IS BORN IT CAN OPEN THE EYES &SEE THE SURROUNDINGS AS IT WAS IN A DARK WORLD FOR NINE MONTHS&APPRECIATE THE PHOTIC STIMULATION OF THE EXTERNAL WORLD.BERA IS THE LATEST SOPHISTICATED TEST TO FIND OUT IF A BABY IS DEAF,THE TEST FINDS OUT IF THE SOUND WEAVES REACH THE BRAINCELLS.
USUALLY AT AGE 30 DAYS A NEW BORN BABY IS ABLE TO 1)VISUALISE AN OBJECT&FIX THAT OBJECT2)OR VISUALISE A SPOT FROM WHERE A SOUND IS COMING.3)IT CAN EVEN COMMUNICATE WITH AN OBJECT WHICH IS MAKING/CREATING A SOUND BY MAKING THROTY SYLLABLES .IF ALL THE THREE ABOVE FINDINGS ARE NOT PRESENT UPTO 90 DAYS A PEDIATRICIAN SHOULD SEE THE BABY.
EXTREMELY GOOD CRY AT BIRTH:
IT IS A SENSIBLE PRESUMPTION THAT IF A BABY CRIES VERY LOUDLY FOR A PROLONGED PERIOD &IF REPEATEDLY KEEPS CRYING THERE IS A THEORETICAL POINT THAT ALL BLOOD VESSELS IN THE BRAIN OPENS &BLOOD SUPPLY TO NEURONES MADE EASY. AT BIRTH ALLTUBES/DUCTS/VESSELS ARE NOT PATENT.SO THE ESTABLISHMENT OF PATENCY OF ALL BRAIN BLOOD VESSELS IMPERATIVE FOR ITS ULTIMATE INTELLECTUAL CAPABILITY DUE TO BETTER BLOOD SUPPLY THAT YIELDS BETTER OXYGEN WHICH IS THE MAIN FOOD FOR ALL CELLS ,SPECIALLY THE NERVE CELLS.
SO WE CAN PRESUME THAT A BABY AT BIRTH CRYING LOUDLY AT BIRTH IS DIFFERENT FROM A BABY NOT CRYING MUCH. THIS OF COURSE CAN BE PROOVED BY A RETROSPECTIVE STUDY.THE MORE LOUD THE BABY CRIES ,MORE PINK THE COLOUR WILL BE INDICATIVE OF BETTER LUNG FUNCTION/EXPANSION,BETTER OXYGEN CO2 DISSOCIATION, BETTER BLOOD SUPPLY TO ALL ORGANS OF BODY,INCLUDING BRAIN.IF THE OPPOSITE BEFALLS ,DEVELOPEMENT OF MENTAL RETARDATION IS A STRONG POSSIBILITY..
CORD ROUND THE NECK:
---------------------------
ABOUT 5-10% OF BABIES NECK GET ENTANGLED IN THE UMBILLICAL CORD WHILE FLOATING IN THE AMNIOTIC FLUID INSIDE THE SACK.SOMETIMES IT MAY LEAD TO A STRANGULATING EFFECT CAUSING FETAL DISTRESS SPECIALLY WHEN THE CORD GOES TWICE OR THRICE AROUND NECK..THIS CAN LITERALLY CAUSE ASPHYXIATION
IN UTERO OR PERINATALLY WHEN COMES OUT PER VIA NATURALIS.DEPENDING ON THE TIGHTNESS OF THE CORD AROUND THE NECK THE OUTCOME IS ALSO VARIABLE.MOST SUCH BABIES ARE BORN WITH VERY LOW OR ZERO APGAR SCORE WHEN IT BECOMES A CHALLANGING TASK FOR THE NEONATOLOGIST TO REVIVE &
RESUCITATE THE BABY. ONLY AN EXPERIENCED PERSON ALONE CAN SUCCESSFULLY RESUCITATE SUCH BABIES TO 100%
GOOD THYROID STATUS IN MOTHER &BABY
----------------------------------------------------
THYROID IS A DUCTLESS GLAND PRODUING THYROXIN A HORMONE INTRICATELLY INTEGRATED WITH INTELLIGENCE.NO THYROID MEANS NO INTELLIGENCE .ALSO IT HAS INFLUENCE OVER ALL THE BODY TISSUES. ITS ABSENCE WILL SELECTIVELY CAUSE BRAIN &BONE DAMAGE IN THE FORMATIVE YEARS.THYROID DIFFICIENCY CAN BE CLINICALLY DIAGNOSED IN 3-6 MONTHS AGE GROUP BABIES.&IS FULLY RECTIFIABLE BY CONTINUOUS THYROID TREATMENT.
Rh-INCOMPATIBILITY.
--------------------------
IF MOTHER IS Rh NEGATIVE, &FOETUS Rh POSITIVE,ABOUT 2-10 % BABIES CAN DEVELOP BLOOD GROUP INCOMPATIBILITY, LEADING TO RBC DESTRUCTION, &CONSEQUENT IRRVERSIBLE BRAIN DAMAGE WITH JAUNDICE ,MUSCLE SPASM, FITS, &MENTAL RETARDATION.
ENVIRONEMENTAL STIMULATION:MOST IMPORTANT CONTINUOUS PROCESS.
------------------------------------------------------------------------------------------
A CHILD'S BRAIN DEVELOPEMENT DEPENDS ON THE FOLLOWING GROSS FACTORS APART FRI=OM THE AFORESAID CAUSES.:-
1)BRAIN MASS MUST GROW &THE SKULL BONES MUST ALLOW THIS ENLARGEMENT/EXPANSION &ACCOMODATE BIGGER MASS BY SUITABLY INCREASING THE INNER SKULL SPACE.
2)THE VARIOUS NUTRITION FACTORS &THYROXIN HELP INTHE BRAIN MASS INCREASE.
3)BY APPROPRIATE STIMULATION OF ALL FIVE SPECIAL SENSES THE CORTICAL NEURONES STORE THE INFORMATIONS RECIEVED FROM TIME TO TIME IN THE FORM OF A' FUNCTIONAL' LAYER ,COMPARABLE TO A COMPUETOR CHIP.THE STIMULI RECIEVED KEEP INCREASING IN NUMBER &QUALITY AS TIME PROGRESSES. BEFORE LEARNING WORDS &SENTENCES BABY LEARNS THE SYLLABLES,LIKE A B C ,WITH PHONATION,THIS SYSTEMATIC WAY OF LEARNING IS A MUST TO SHOW GROWTH &PROGRESS.
STORY OF WOLF RAMAN
---------------------------
THIS IS A TRUE STORY OCCURED AT VELLORE-TAMILNADU-INDIA.
PUBLISHED ALL OVER THE WORLD IN ALL NEWSPAPERS 50 YEARS BACK.
A CHILD AGED ABOUT 5 WAS FOUND MAKING NOICE &JUMPING LIKE WOLF IN A JUNGLE SPOTTED BY FEW HUNTERS, WHO BROUGHT CHILD FROM JUNGLE TO CMC HOSPITAL.VARIOUS SPECIALITY DOCTORS FROM VARIOUS PARTS OF THE WORLD
POURED INTO CMC TO SEE &STUDY THE BABY.INTER NATIONAL SYMPOSIUM WERE CONDUCTED..EXCEPT FOR THE EXTERNAL FEATURES OF A HUMAN CHILD BOYHAD ALL THE CHARECTERS OF ANIMALS ONLY &DIED IN HOSPITAL IN ABOUT 2MONTHES PROBALY DUE TO ENVIRONMENTAL SEPERATION
DISCUSSION:
THIS CHILD MUST HAVE BEEN ABDUCTED FROM A VILLAGE BY A WOLF/FOX,OR MUST HAVE BEEN ABANDENED BY A MOTHER AFTER AN ILLEGITIMATE PREGNANCY.THIS CHILD NEVER HAD ANY STIMULATION FROM HUMANS AT ANY TIME..WHAT WAS STRICKINGLY OBVIOUS WAS IT POSSESSED ALL THE CHARECTERS OF ANIMAL&NOTHING FROM HUMANS..
THIS EXPLAINS HOW AN ENVIRONE MENT IS IMPORTANT IN SHAPING FOR ITS INTELLECTUAL STIMULATION,FOR ITS ULTIMATE BRAIN GROWTH QUQLITATIVELY EMOTIONALLY FOR ITS INTELLECTUAL OUTCOME.
----------------------------------------
A NEW BORN BAY' INTELLIGENCE DEPENDS UPON ITS INHERENT ABILITIES,&MANY OTHER EXTERNAL INFLUENCING FACTORS..ANY OR MANY OF THE FOLLOWING FACTORS MAY INTERFERE WITH THE THE BRAIN DEVELOPMENT &ITS INTELLIGENCE.
1)GENETIC MAKE UP
2)GOOD APGAR SCORE AT BIRTH.
3)INTRACRANIAL HEMORRHAGE.
4)CORD AROUND THE NECK PRIOR TO DELIVERY.
5)FETAL DISTRESS.
6)GOOD HEAD CIRCUMFERENCE AT BIRTH.
7)NO MATERNAL ANEMIA/HYPERTENSION/ MALNUTRITION.
8)GOOD VISION AT BIRTH.
9)GOOD HEARING CAPABILITY AT BIRTH.
10)EXTREMELY GOOD CRY AT BIRTH
(OPENS THE PATENCY OF ALL BRAIN BLOOD VESSELS)
11)GOOD THYROID STATUS (EU THYROID) IN MOTHER &BABY.
12)ENVIRONMENTAL STIMULATION-A CONTINUOUS PROCESS.
G E NE T I C M A K E U P
---------------------------
GENES ARE ULTRA(ELECTRON )MICROSCOPIC STRUCTURES.WHICH CARRY &PROPAGATE THE INTELLECTUAL CAPABILITY,OF ONE GENERATION TO ANOTHER GENERATION ALONG WITH MANY OTHER QUALITIES GOOD OR BAD ABOUT THE INDIVIDUALS CONCERNED.EDUCATION &INTELLIGENCE ARE NOT THE SAME .
AN EDUCATED PERSON NEED NOT BE INTELLIGENT&VICE VERSA.BUT EDUCATION DOES INCREASE THE INTELLECTUAL LEVEL.MANY UNEDUCATED MAY BE MORE INTELLIGENT THAN THE EDUCATED SO THE INTELLECTUAL TRAIT IS CARRIED FROM ONE GENERATION TO ANOTHER &OFTEN REFLECTED IN A CUMULATIVE MANNER,THROUGH THE GENES,CARRYING
TO POSITIVE PRINT IN THE NEXT GENERATION.TECHNICALLY THEY ARE REFERRED AS RNA,&DNA.THE FIRST GENERATION INDIVIDUAL MAY BE INTELLIGENT IN ONE WALK OF LIFE THE SECOND GENERATION COULD BE INTELLIGENT IN ANOTHER FIELD.THE THIRD GENERATION WILL HAVE INTELLIGENCE OF ITS OWN PLUS THE PREVIOUS TWO GENERATIONS INTELLIGENCE.THIS IS HOW THE INTELLIGENCE TREE KEEPS GROWING.
G O O D A P GA R S C O R E A T B I R T H.
----------------------------------------------
THIS MEANS THE CRY, COLOUR, ACTIVITY,REFLEXES,HEART RATE RESPIRATORY RATE ARE NORMAL WITHIN 10 Mts OF BIRTH&THAT THERE IS NO ASPHYXIA WHICH MEANS1)THE BRAIN BLOOD VESSELS ARE NOT PATENT ,OR NOT FULLY OPEN ,2)THERE IS NO ENOUGH OXYGEN SUPPLY TO THE BRAIN CELLS,3)THERE IS POOR GAS EXCHANGE IN THE LUNGS,WHICH MIGHT NOT HAVE EXPANDED FULLY.ULTIMATELY O2 SUPPLY TO BRAIN DECIDES THE NUMBER OF NEURONAL CELLS TO BE ACTIVE OR INACTIVE THE INACTIVE CELLS IF NOT PROPERLY OXYGENATED WITHIN 10-20 Mts WILL DIE & BECOME A SCAR THAT WILL LEAD ON TO THE DEVELOPMENT OF A CEREBRAL PALSY,LEADING TO MENTAL RETARDATION.
CEREBRAL PALSY MEANS ,PARALYSIS, OR MALFUNCTION,&PARTIAL OR TOTAL LOSS OF FUNCTION OF NEURONS AT CEREBRUM TO LACK OF BLOOD SUPPLY LEADING TO INSUFFICIENT OXYGEN ,TO NEURONS LEADING TO AN ALTERATION OF MUSCLE TONE&LOSS OF INTELLECTUAL FUNCTION LEADING TO,MENTAL RETARDATION OF VARIABLE DEGREES FROM POOR ACADEMIC PERFORMANCE TO TOTAL IDIOCY,OFTEN WITH INCREASED SPASTICITY OF ALL MUSCLES(ALSO KNOWN AS LITTLE'S DISEASE)(LITTLE WAS AN OUTSTANDING ORTHOPEDIC SURGEON IN THE WHOLE OF EUROPE WHO DISCOVERED THAT CEREBRAL PALSY IS DUE TO ASPHYXIA NEONATORUM &NOT PRIMARILY AN ORTHO CONDITION--THANKS TO DR LITTLE WHOSE OBSERVATION WAS BETTER THAN AN OBSTETRICIAN OF YESTER YEARS.
INTRA CRANIAL HAEMORRHAGE:
MANY NEW BORN BABIES SUFFER FROM THIS DISORDER, MAINLY DUE TOA A DEFICIENCY IN THE COAGULATION MECHANISM(FACTOR DEFICIENCY),AND THIS IS DUE TO A GENETIC DISORDER.THE HEMORRHAGE AGAIN IS VARIABLE AS PER THE QUANTITY OF THE DEFECT.INTRAVENTRICULAR HEMORRHAGE IS THE SEVEREST OF ALL,PRODUCING VERY MANY CNS COMPLICATIONS,SUCH AS FITS,SPASTICITY OF MUSCLES ,PARALYSIS,INTELLECTUAL DEFECT OF VARIABLE DEGREES.
FETAL DISTRESS:
OCCURS DURING ANTIPARTUM OR AT INTRAPARTUM PERIOD.SEVERE FETAL DISTRESS LEADS TO RESPIRATORY OR METABOLIC ACIDOSIS.CAN OCCUR IN THE FOLLOWING CONDITIONS:
1)INTRUTERINE GROWTH RETARDATION.
2)POST DATED GESTATION.
3)MATERNAL DIABETES MELLITUS
4)RHESUS SENSITISED PREGNANCY.
5)PREVIOUS H/O OF STILL BIRTH.
6)MATERNAL HYPERTENSION
7)FETAL HYPOXIA.
8)MATERNAL FEVER.
9)MATERNAL HYPERTHYROIDISM
10)FETAL ANEMIA, ARRHYTHMIA
11)PLACENTAL TRANSFER OF DRUGS
12)SLEEP STATE
13)PREMATURITY.
ALL THE ABOVE LEAD TO LESS BLOOD SUPPLY TO BRAIN RESULTING IN LESS OXYGEN SUPPLY TO CEREBRAL NEURONS THAT CAN JEOPARDISE THE INTELLECTUAL DEVELOPMENT
GOOD HEAD CIRCUMFERENCE AT BIRTH
---------------------------------------------
A BABY SHOULD HAVE AT LEAST 35 CM OF HEAD CIRCUMFERENCE.AT BIRTH.
1-2 CM LESS OR MORE ,MAY BE CONSIDERED AS VARIATIONS.ANYTHING LESSER MAY MEAN MICROCEPHALY &ANYTHING MORE MAY MEAN HYDROCEPHALUS, & NEEDS SERIAL MEASUREMENT FOR ASSESSMENT.&BOTH WILL AFFECT THE INTELLIGENCE GROSSLY.IN MICROCEPHALY IT IS NON DEVELOPEMENT,&IN HYDROCEPHALUS IT IS NEURONAL CELL DESTRUCTION BY THE SURROUNDING CSF PRESSURE THUS THE INTELLIGENCE DEVELOPMENT IS AFFECTED EVEN AT FOUNDATION LEVEL OF THE FUTURE CONSTRUCTION.
MATERNAL ANAEMIA/HYPERTENSION'S/MALNUTRITION.
MATERNAL ANAEMIA WILL LEAD TO FETAL ANAEMIA RESULTING IN POOR DELIVERY OF OXYGEN TO DEVELOPING NEURONAL CELLS THROUGH HEMOGLOBIN.AN ANOXIC CELL IS A WEEK CELL.HYPERTENSION WILL LEAD TO EXESS BLOOD FLOW&HEMORRHAGIC TENDENCY RESULTING IN CELL DEATH. MALNUTRITION WILL AFFECT CELL ANABOLISM AS PROTIEN IS NECESSARY FOR CONSTRUCTION&CARBOHYDRATE FOR FUEL.ALL THESE CONTRIBUTE FOR A POOR QUALITY NEURONAL CELL GROWTH &DEVELOPMENT OF INTELLIGENCE IS VERY DIFFICULT IN SUCH A DAMAGED CELL.
GOOD VISION AT BIRTH.
----------------------------
EYE IS SAID TO BE THE WINDOW OF THE BRAIN.MOST OF THE INFORMATION ENTERS INTO THE BRAIN VISUALLY&IS STORED LIKE A COMPUTER CHIP.INTELLIGENCE IS NOTHING BUT A COLLECTION OF INFORMATION,STORED, &RE UTILISATION OF THESE INFORMATION WHEN NECESSARY. OF THE NATURES FIVE GIFTED SPECIAL SENSES ,VISION IS BY FOR THE BEST.CHILDREN ARE GIVEN AUDIO VISUAL STIMULI TO IMPROVE THE INTELLECTUAL CAPACITY,DURING THEIR ATTEMPT TO LEARN.VARIOUS CONGENITAL EYE DEFECT MAY CONTRIBUTE DEFECTIVE VISION,LEADING TO INTERFERENCE WITH INTELLIGENCE FORMATION Eg :CONGENITAL CATARACT IN RUBELLA SYNDROME.
GOOD HEARING CAPABILITY :
WHEN DOES A NEWBORN START HEARING? WHEN CAN IT START SEEING?
BOTH ARE PRESENT AT BIRTH.IN FACT CAN HEAR &APPRECIATE SOUND WHEN IT IS IN UTERO WHEN A PREGNANT MOTHER SINGS THE BABY IS SUBJECTED TO THE VIBRATION TRANSMITTED THROUGH THE AMNIOTIC FLUID&THUS GETS USED TO SOUND APPRECIATION,UNLESS THERE IS A NEUROLOGICAL DEFICIT,OR A HYPOTHYROID STATE, AS SOON AS THE BABY IS BORN IT CAN OPEN THE EYES &SEE THE SURROUNDINGS AS IT WAS IN A DARK WORLD FOR NINE MONTHS&APPRECIATE THE PHOTIC STIMULATION OF THE EXTERNAL WORLD.BERA IS THE LATEST SOPHISTICATED TEST TO FIND OUT IF A BABY IS DEAF,THE TEST FINDS OUT IF THE SOUND WEAVES REACH THE BRAINCELLS.
USUALLY AT AGE 30 DAYS A NEW BORN BABY IS ABLE TO 1)VISUALISE AN OBJECT&FIX THAT OBJECT2)OR VISUALISE A SPOT FROM WHERE A SOUND IS COMING.3)IT CAN EVEN COMMUNICATE WITH AN OBJECT WHICH IS MAKING/CREATING A SOUND BY MAKING THROTY SYLLABLES .IF ALL THE THREE ABOVE FINDINGS ARE NOT PRESENT UPTO 90 DAYS A PEDIATRICIAN SHOULD SEE THE BABY.
EXTREMELY GOOD CRY AT BIRTH:
IT IS A SENSIBLE PRESUMPTION THAT IF A BABY CRIES VERY LOUDLY FOR A PROLONGED PERIOD &IF REPEATEDLY KEEPS CRYING THERE IS A THEORETICAL POINT THAT ALL BLOOD VESSELS IN THE BRAIN OPENS &BLOOD SUPPLY TO NEURONES MADE EASY. AT BIRTH ALLTUBES/DUCTS/VESSELS ARE NOT PATENT.SO THE ESTABLISHMENT OF PATENCY OF ALL BRAIN BLOOD VESSELS IMPERATIVE FOR ITS ULTIMATE INTELLECTUAL CAPABILITY DUE TO BETTER BLOOD SUPPLY THAT YIELDS BETTER OXYGEN WHICH IS THE MAIN FOOD FOR ALL CELLS ,SPECIALLY THE NERVE CELLS.
SO WE CAN PRESUME THAT A BABY AT BIRTH CRYING LOUDLY AT BIRTH IS DIFFERENT FROM A BABY NOT CRYING MUCH. THIS OF COURSE CAN BE PROOVED BY A RETROSPECTIVE STUDY.THE MORE LOUD THE BABY CRIES ,MORE PINK THE COLOUR WILL BE INDICATIVE OF BETTER LUNG FUNCTION/EXPANSION,BETTER OXYGEN CO2 DISSOCIATION, BETTER BLOOD SUPPLY TO ALL ORGANS OF BODY,INCLUDING BRAIN.IF THE OPPOSITE BEFALLS ,DEVELOPEMENT OF MENTAL RETARDATION IS A STRONG POSSIBILITY..
CORD ROUND THE NECK:
---------------------------
ABOUT 5-10% OF BABIES NECK GET ENTANGLED IN THE UMBILLICAL CORD WHILE FLOATING IN THE AMNIOTIC FLUID INSIDE THE SACK.SOMETIMES IT MAY LEAD TO A STRANGULATING EFFECT CAUSING FETAL DISTRESS SPECIALLY WHEN THE CORD GOES TWICE OR THRICE AROUND NECK..THIS CAN LITERALLY CAUSE ASPHYXIATION
IN UTERO OR PERINATALLY WHEN COMES OUT PER VIA NATURALIS.DEPENDING ON THE TIGHTNESS OF THE CORD AROUND THE NECK THE OUTCOME IS ALSO VARIABLE.MOST SUCH BABIES ARE BORN WITH VERY LOW OR ZERO APGAR SCORE WHEN IT BECOMES A CHALLANGING TASK FOR THE NEONATOLOGIST TO REVIVE &
RESUCITATE THE BABY. ONLY AN EXPERIENCED PERSON ALONE CAN SUCCESSFULLY RESUCITATE SUCH BABIES TO 100%
GOOD THYROID STATUS IN MOTHER &BABY
----------------------------------------------------
THYROID IS A DUCTLESS GLAND PRODUING THYROXIN A HORMONE INTRICATELLY INTEGRATED WITH INTELLIGENCE.NO THYROID MEANS NO INTELLIGENCE .ALSO IT HAS INFLUENCE OVER ALL THE BODY TISSUES. ITS ABSENCE WILL SELECTIVELY CAUSE BRAIN &BONE DAMAGE IN THE FORMATIVE YEARS.THYROID DIFFICIENCY CAN BE CLINICALLY DIAGNOSED IN 3-6 MONTHS AGE GROUP BABIES.&IS FULLY RECTIFIABLE BY CONTINUOUS THYROID TREATMENT.
Rh-INCOMPATIBILITY.
--------------------------
IF MOTHER IS Rh NEGATIVE, &FOETUS Rh POSITIVE,ABOUT 2-10 % BABIES CAN DEVELOP BLOOD GROUP INCOMPATIBILITY, LEADING TO RBC DESTRUCTION, &CONSEQUENT IRRVERSIBLE BRAIN DAMAGE WITH JAUNDICE ,MUSCLE SPASM, FITS, &MENTAL RETARDATION.
ENVIRONEMENTAL STIMULATION:MOST IMPORTANT CONTINUOUS PROCESS.
------------------------------------------------------------------------------------------
A CHILD'S BRAIN DEVELOPEMENT DEPENDS ON THE FOLLOWING GROSS FACTORS APART FRI=OM THE AFORESAID CAUSES.:-
1)BRAIN MASS MUST GROW &THE SKULL BONES MUST ALLOW THIS ENLARGEMENT/EXPANSION &ACCOMODATE BIGGER MASS BY SUITABLY INCREASING THE INNER SKULL SPACE.
2)THE VARIOUS NUTRITION FACTORS &THYROXIN HELP INTHE BRAIN MASS INCREASE.
3)BY APPROPRIATE STIMULATION OF ALL FIVE SPECIAL SENSES THE CORTICAL NEURONES STORE THE INFORMATIONS RECIEVED FROM TIME TO TIME IN THE FORM OF A' FUNCTIONAL' LAYER ,COMPARABLE TO A COMPUETOR CHIP.THE STIMULI RECIEVED KEEP INCREASING IN NUMBER &QUALITY AS TIME PROGRESSES. BEFORE LEARNING WORDS &SENTENCES BABY LEARNS THE SYLLABLES,LIKE A B C ,WITH PHONATION,THIS SYSTEMATIC WAY OF LEARNING IS A MUST TO SHOW GROWTH &PROGRESS.
STORY OF WOLF RAMAN
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THIS IS A TRUE STORY OCCURED AT VELLORE-TAMILNADU-INDIA.
PUBLISHED ALL OVER THE WORLD IN ALL NEWSPAPERS 50 YEARS BACK.
A CHILD AGED ABOUT 5 WAS FOUND MAKING NOICE &JUMPING LIKE WOLF IN A JUNGLE SPOTTED BY FEW HUNTERS, WHO BROUGHT CHILD FROM JUNGLE TO CMC HOSPITAL.VARIOUS SPECIALITY DOCTORS FROM VARIOUS PARTS OF THE WORLD
POURED INTO CMC TO SEE &STUDY THE BABY.INTER NATIONAL SYMPOSIUM WERE CONDUCTED..EXCEPT FOR THE EXTERNAL FEATURES OF A HUMAN CHILD BOYHAD ALL THE CHARECTERS OF ANIMALS ONLY &DIED IN HOSPITAL IN ABOUT 2MONTHES PROBALY DUE TO ENVIRONMENTAL SEPERATION
DISCUSSION:
THIS CHILD MUST HAVE BEEN ABDUCTED FROM A VILLAGE BY A WOLF/FOX,OR MUST HAVE BEEN ABANDENED BY A MOTHER AFTER AN ILLEGITIMATE PREGNANCY.THIS CHILD NEVER HAD ANY STIMULATION FROM HUMANS AT ANY TIME..WHAT WAS STRICKINGLY OBVIOUS WAS IT POSSESSED ALL THE CHARECTERS OF ANIMAL&NOTHING FROM HUMANS..
THIS EXPLAINS HOW AN ENVIRONE MENT IS IMPORTANT IN SHAPING FOR ITS INTELLECTUAL STIMULATION,FOR ITS ULTIMATE BRAIN GROWTH QUQLITATIVELY EMOTIONALLY FOR ITS INTELLECTUAL OUTCOME.
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Tuesday, January 12, 2010
SRM Specialty Hospital
SRM University
Ramapuram – Chennai
Tamilnadu – India
Neonatal Resuscitation New Concept
STATISTICS
1.Asphyxia > 900000/- year W.H.O 2000-2003.
2.23% of Neonatal deaths are Asphyxia Lancet 2005
3.4 million Neonatal death – World wide.
4.Neonatal death 20% China – 2005 developed countries have protocols/programmes like CME.
5.CPincidence – 2 per 1000 population
6.Asphyxia – Mortality More than morbidity.
7.CP- Prevalance 4 per 1000 live births.
8.One – out of 4 ‘bad’ babies – CP
ASPHYXIA
1. What is Asphyxia literally?
2. Is it a misnomer here?
3. Is it a CNS depression due to
bio-chemical metabolic change?
4. Can we call all cyanosis as
asphyxia?
5. What is asphyxia Neonatorum?
Pertinent Questions-NRT
►What is it?
►Where is it done?
►How is it done?
►Who can do it?
►What are the required Equipments?
►What is Asphyxia Neonatorum?
►Is “Asphyxia” a right word here?
►What are the ill effects of failure of NR (Littles’ disease)
►Can we correct it to 100% if so how?
Good Old Dictum – ABC
What is A/B/C?
If no cry or respiration
a) Intubations by ET tube.
b) Oxygen by catheter / mask / hood
c) Ambu bag inflation / deflation.
d) Positive pressure ventilation.
e) Neonatal intensive care unit admission
Is it all necessary?
Does it yield the desired fruit?
If not why should we dothe same?
Why should not we change for better?
New Technique (Designed by author)
“Old Order changeth,
Yielding place to new”
PNEUMONICS : TTDS (Forget ABC)
•T : Thirupathi
•T : Thirumala
•D : Devasthanam
•S : Sanctorum
Further Expansion
T FOR TACTILE - EMBRACES
a. Tapping Baby’s back
b. Tapping Baby’s soles
c. Tapping Baby’s Toes
d. Squeezing Baby’s Ear Lobe with gauze
e. Pushing left index finger into baby’s left molar
f. Squeezing chest through Axillae
g. “Feel of Bite” Sense: Massester Muscle Tone.
T For Tracheal - Embraces
•NG Tube Stimulation through Nose / Mouth.
•NG Tube Stimulation at Tracheal opening.
•Tracheal Suction without ET Tube
•Aim 1. Stimulation by touch
2. Suction of Aspirated
Amniotic fluid, Meconium,
Vernix casseosa
D For Drugs - Embraces
Drug stimulation by following drugs.
a.Glucose 10 – 20 %
b.Soda Bicarb 7.5% 99%
c.Beclamathasone inhaler by Special tubing + Thoracic Squeezing in Rhythmic fashion – 0.75%
d.Adrenalin
e.Deriphylline
f.Dexamethasone – Inj – If necessary
TTDS – Success rate 100% - If
1.FH was present 5 minutes before delivery
2.No cord around the neck more than Twice.
3.No cardiac / Pulmonary / CNS / Tracheobronchial anatomical abnormality.
4.No Hiatus hernia.
5.No birth weight below 1200 gms
6.No RDS / Foetal aspiration syndrome / HMD.
7.No previous H/O foetal death
8.No Maternal diabetes / hypertension / drug withdrawal
9.No Spinal shock due to spinal anaestheria
10.No Apgar score at 0 in first 5 mts.
11.No “feel of bite” at any time during resuscitation .
12.No Placenta Previa
A. Resuscitation Team - Work Assignment
1. Baby receiving
2.Baby positioning – Neck rest – head down
3.Warmer light
4.Suction machine – On / off
5.Chest compression / Tactile Stimulation.
B. Time Keeper
1.Notes birth time
2.Announces every minute by counts.
3.Announces HR / RR - Every Minute
4.Pulse Oxymeter Reader every minute
5.Venesection instruments.
6.umbilical cathetrisation – IV drip.
C. Equipment Procurement
1.Soda Bicarb
2.25% Glucose
3.Deriphylline
4.Dexamethasone
5.Beclamethasone Inhaler
6.Laryngoscope
7.suction catheters / Sterile Hand gloves - Size
8.NG tube size 5,8
9.Butterfly needle – No. 24
10. 20 ml / 5ml syringe
11. Needle No. 26.
12. Vitamin K
13. Styptochrome
14. Calcium
15. Diazapam
16. Epsolin
D. Resuscitator / commander / Chief coordinator (Doctor)
Baby Crying Score (designed by author as per the cry duration in seconds / minutes)
n0 - No cry at Birth and at any time
n1- 3 Average cry (5-10 Sec after each stimulus)
n4- 6 Good cry (> than 15 sec after stimulus interruptedly for 2 hrs)
n7- 9 Very Good luxurious cry > 30 seconds after each stimulus for 6 hrs or more.
Score 5 & above – Excellent cry - brain blood vessels – open fully.
If no cry - asphyxia develops? (cyanosis)
Asphyxia – causes CP / MR / Low academic performances
Behaviour problem like ADHD
Trump card of Neonatal Resuscitation if there is substandard cry
§Tracheal Suction
§Thoracic Squeezing
§Correction of Hypoglycemia
§Correction of Acidosis
§If child cries immediately after NaHCo3 it means uncorrected metabolic acidosis - now corrected
Drug Dose
ØFirst Shot : NaHCo3 (5ml) + 10% Glucose (5 ml) intra umbilically
ØSecond shot : If there is no satisfactory cry repeat same after 5 minutes.
ØRepeat Every 5 minutes for 3-5 times according to necessity.
Aggressive Neonatal Resuscitation Indication
Born as if still birth.
Born with low Apgar Below 5 after 5 minutes
Obvious Cyanosis
No cry for 5 minutes after delivery.
Gross Hypotonicity generalized
HR < 60 / Minute
RR < 16 / Minute
Precious Child
Procedure
Continuous chest compression & Tracheal Suction
Beclamethosone inhalar through tube
NaHCo3 + 25% Glucose – Large dose
Umbilical Venous Cathetrization
Defibrillation – When all measures fail.
Author’s
►Professional Experience : 45 years
►Pure Pediatrics experience : 35 years
►100% success rate in NRT : 20 years
Thank You
SRM University
Ramapuram – Chennai
Tamilnadu – India
Neonatal Resuscitation New Concept
STATISTICS
1.Asphyxia > 900000/- year W.H.O 2000-2003.
2.23% of Neonatal deaths are Asphyxia Lancet 2005
3.4 million Neonatal death – World wide.
4.Neonatal death 20% China – 2005 developed countries have protocols/programmes like CME.
5.CPincidence – 2 per 1000 population
6.Asphyxia – Mortality More than morbidity.
7.CP- Prevalance 4 per 1000 live births.
8.One – out of 4 ‘bad’ babies – CP
ASPHYXIA
1. What is Asphyxia literally?
2. Is it a misnomer here?
3. Is it a CNS depression due to
bio-chemical metabolic change?
4. Can we call all cyanosis as
asphyxia?
5. What is asphyxia Neonatorum?
Pertinent Questions-NRT
►What is it?
►Where is it done?
►How is it done?
►Who can do it?
►What are the required Equipments?
►What is Asphyxia Neonatorum?
►Is “Asphyxia” a right word here?
►What are the ill effects of failure of NR (Littles’ disease)
►Can we correct it to 100% if so how?
Good Old Dictum – ABC
What is A/B/C?
If no cry or respiration
a) Intubations by ET tube.
b) Oxygen by catheter / mask / hood
c) Ambu bag inflation / deflation.
d) Positive pressure ventilation.
e) Neonatal intensive care unit admission
Is it all necessary?
Does it yield the desired fruit?
If not why should we dothe same?
Why should not we change for better?
New Technique (Designed by author)
“Old Order changeth,
Yielding place to new”
PNEUMONICS : TTDS (Forget ABC)
•T : Thirupathi
•T : Thirumala
•D : Devasthanam
•S : Sanctorum
Further Expansion
T FOR TACTILE - EMBRACES
a. Tapping Baby’s back
b. Tapping Baby’s soles
c. Tapping Baby’s Toes
d. Squeezing Baby’s Ear Lobe with gauze
e. Pushing left index finger into baby’s left molar
f. Squeezing chest through Axillae
g. “Feel of Bite” Sense: Massester Muscle Tone.
T For Tracheal - Embraces
•NG Tube Stimulation through Nose / Mouth.
•NG Tube Stimulation at Tracheal opening.
•Tracheal Suction without ET Tube
•Aim 1. Stimulation by touch
2. Suction of Aspirated
Amniotic fluid, Meconium,
Vernix casseosa
D For Drugs - Embraces
Drug stimulation by following drugs.
a.Glucose 10 – 20 %
b.Soda Bicarb 7.5% 99%
c.Beclamathasone inhaler by Special tubing + Thoracic Squeezing in Rhythmic fashion – 0.75%
d.Adrenalin
e.Deriphylline
f.Dexamethasone – Inj – If necessary
TTDS – Success rate 100% - If
1.FH was present 5 minutes before delivery
2.No cord around the neck more than Twice.
3.No cardiac / Pulmonary / CNS / Tracheobronchial anatomical abnormality.
4.No Hiatus hernia.
5.No birth weight below 1200 gms
6.No RDS / Foetal aspiration syndrome / HMD.
7.No previous H/O foetal death
8.No Maternal diabetes / hypertension / drug withdrawal
9.No Spinal shock due to spinal anaestheria
10.No Apgar score at 0 in first 5 mts.
11.No “feel of bite” at any time during resuscitation .
12.No Placenta Previa
A. Resuscitation Team - Work Assignment
1. Baby receiving
2.Baby positioning – Neck rest – head down
3.Warmer light
4.Suction machine – On / off
5.Chest compression / Tactile Stimulation.
B. Time Keeper
1.Notes birth time
2.Announces every minute by counts.
3.Announces HR / RR - Every Minute
4.Pulse Oxymeter Reader every minute
5.Venesection instruments.
6.umbilical cathetrisation – IV drip.
C. Equipment Procurement
1.Soda Bicarb
2.25% Glucose
3.Deriphylline
4.Dexamethasone
5.Beclamethasone Inhaler
6.Laryngoscope
7.suction catheters / Sterile Hand gloves - Size
8.NG tube size 5,8
9.Butterfly needle – No. 24
10. 20 ml / 5ml syringe
11. Needle No. 26.
12. Vitamin K
13. Styptochrome
14. Calcium
15. Diazapam
16. Epsolin
D. Resuscitator / commander / Chief coordinator (Doctor)
Baby Crying Score (designed by author as per the cry duration in seconds / minutes)
n0 - No cry at Birth and at any time
n1- 3 Average cry (5-10 Sec after each stimulus)
n4- 6 Good cry (> than 15 sec after stimulus interruptedly for 2 hrs)
n7- 9 Very Good luxurious cry > 30 seconds after each stimulus for 6 hrs or more.
Score 5 & above – Excellent cry - brain blood vessels – open fully.
If no cry - asphyxia develops? (cyanosis)
Asphyxia – causes CP / MR / Low academic performances
Behaviour problem like ADHD
Trump card of Neonatal Resuscitation if there is substandard cry
§Tracheal Suction
§Thoracic Squeezing
§Correction of Hypoglycemia
§Correction of Acidosis
§If child cries immediately after NaHCo3 it means uncorrected metabolic acidosis - now corrected
Drug Dose
ØFirst Shot : NaHCo3 (5ml) + 10% Glucose (5 ml) intra umbilically
ØSecond shot : If there is no satisfactory cry repeat same after 5 minutes.
ØRepeat Every 5 minutes for 3-5 times according to necessity.
Aggressive Neonatal Resuscitation Indication
Born as if still birth.
Born with low Apgar Below 5 after 5 minutes
Obvious Cyanosis
No cry for 5 minutes after delivery.
Gross Hypotonicity generalized
HR < 60 / Minute
RR < 16 / Minute
Precious Child
Procedure
Continuous chest compression & Tracheal Suction
Beclamethosone inhalar through tube
NaHCo3 + 25% Glucose – Large dose
Umbilical Venous Cathetrization
Defibrillation – When all measures fail.
Author’s
►Professional Experience : 45 years
►Pure Pediatrics experience : 35 years
►100% success rate in NRT : 20 years
Thank You
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