Clin Exp Emerg Med 2016;3(S):S62-S65 http://dx.doi.org/10.15441/ceem.16.135
2015 Korean Guidelines for Cardiopulmonary Resuscitation Ai-Rhan Ellen Kim1, Han Suk Kim2, Su Jin Cho3, Yong Sung Choi4, Eun Sun Kim5, Hye Won Park6, Yong Hoon Cheon7, Moon Sung Park8, Yoon Sil Chang9, Young Han Kim10, Dong Yeon Kim11, Hee Jo Yoon12, Yeon Hee Kim13, Sung Phil Chung14, Sung Oh Hwang15 1
Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea 3 Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea 4 Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea 5 Department of Pediatrics, Kangwon National University College of Medicine, Chuncheon, Korea 6 Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea 7 Department of Pediatrics, Inha University College of Medicine, Incheon, Korea 8 Department of Pediatrics, Ajou University College of Medicine, Suwon, Korea 9 Department of Pediatrics, Sungkyungkwan University School of Medicine, Seoul, Korea 10 Department of Obstetrics and Gynecology, Yonsei University of College of Medicine, Seoul, Korea 11 Department of Nursing, The Catholic University of Korea School of Nursing, Seoul, Korea 12 Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, Cheonan, Korea 13 Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea 14 Department of Emergency Medicine, Yonsei Universtiy College of Medicine, Seoul, Korea 15 Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea 2
eISSN: 2383-4625
Received: 16 February 2016 Revised: 19 March 2016 Accepted: 19 March 2016 Correspondence to: Ai-Rhan Ellen Kim Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail: [email protected]
The following is a summary of the 2015 Korean Neonatal Resuscitation Guidelines. An extensive review of scientific evidence by experts of Neonatal Resuscitation Committee for the 2015 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care including neonatologists, nurse, obstetrician, perinatologist, and anesthesiologist was performed to update the 2011 Korean Neonatal Resuscitation Guidelines.
OVERVIEW It has been reported that approximately 85% of term babies will start spontaneous breathing within 10 to 30 seconds after birth, an additional 10% will respond to drying and stimulation for breathing, about 3% will breathe after positive-pressure ventilation (PPV), 2% will need intubation, and 0.1% will require chest compression and/or epinephrine during transition to extrauterine life.1-3 One of the key factors for neonatal resuscitation is anticipation. Determining who will require resuscitation, what equipment needs to be prepared, whom to join, and how each members should participate in the resuscitation are all important factors in anticipating neonatal deterioration. Beginning resuscitation with antenatal counseling and a team briefing are also important.4,5 Heart rate and respiration are used to identify the need for neonatal resuscitation and to assess response to resuscitation. Heart rate could be checked by either auscultating along the left S62
How to cite this article: Kim AR, Kim HS, Cho SJ, Choi YS, Kim ES, Park HW, Cheon YH, Park MS, Chang YS, Kim YH, Kim DY, Yoon HJ, Kim YH, Chung SP, Hwang SO. Part 7. Neonatal resuscitation: 2015 Korean Guidelines for Cardiopulmonary Resuscitation. Clin Exp Emerg Med 2016;3(S):S62-S65.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/).
Copyright © 2016 The Korean Society of Emergency Medicine
Supplementary
Part 7. Neonatal resuscitation:
Ai-Rhan Ellen Kim, et al.
side of chest or palpating the umbilical cord base. If the heart rate cannot be determined by auscultation/palpation and the baby is not vigorous, pulse oximetry (could underestimate heart rate) or cardiac monitoring can be used for alternatives measures.6-9 Oxygen saturation determined by pulse oximetry indicates color, a third vital sign. The most sensitive indicator of a successful resuscitation is an increase in heart rate. The critical factor to achieve successful neonatal resuscitation is an effective ventilation.
NEONATAL RESUSCITATION ALGORITHM Newly born term infants who are breathing or crying and have a good tone immediately after birth should be dried and taken to the mother for routine care, with continuous evaluation (Fig. 1). However, preterm or term infants who are not breathing or crying and have poor tone should be dried and stimulated to initiate breathing, and kept in a position to open the airway effectively. It Birth
Term? Breathing or crying? Good tone?
Provide initial care (dry, warm, and clear airway)
Assess breathing, HR
Routine care
HR≥ 100/min, labored breathing or persistently cyanotic
HR
2015 Korean Guidelines for Cardiopulmonary Resuscitation Ai-Rhan Ellen Kim1, Han Suk Kim2, Su Jin Cho3, Yong Sung Choi4, Eun Sun Kim5, Hye Won Park6, Yong Hoon Cheon7, Moon Sung Park8, Yoon Sil Chang9, Young Han Kim10, Dong Yeon Kim11, Hee Jo Yoon12, Yeon Hee Kim13, Sung Phil Chung14, Sung Oh Hwang15 1
Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea 3 Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea 4 Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea 5 Department of Pediatrics, Kangwon National University College of Medicine, Chuncheon, Korea 6 Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea 7 Department of Pediatrics, Inha University College of Medicine, Incheon, Korea 8 Department of Pediatrics, Ajou University College of Medicine, Suwon, Korea 9 Department of Pediatrics, Sungkyungkwan University School of Medicine, Seoul, Korea 10 Department of Obstetrics and Gynecology, Yonsei University of College of Medicine, Seoul, Korea 11 Department of Nursing, The Catholic University of Korea School of Nursing, Seoul, Korea 12 Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, Cheonan, Korea 13 Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea 14 Department of Emergency Medicine, Yonsei Universtiy College of Medicine, Seoul, Korea 15 Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea 2
eISSN: 2383-4625
Received: 16 February 2016 Revised: 19 March 2016 Accepted: 19 March 2016 Correspondence to: Ai-Rhan Ellen Kim Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea E-mail: [email protected]
The following is a summary of the 2015 Korean Neonatal Resuscitation Guidelines. An extensive review of scientific evidence by experts of Neonatal Resuscitation Committee for the 2015 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care including neonatologists, nurse, obstetrician, perinatologist, and anesthesiologist was performed to update the 2011 Korean Neonatal Resuscitation Guidelines.
OVERVIEW It has been reported that approximately 85% of term babies will start spontaneous breathing within 10 to 30 seconds after birth, an additional 10% will respond to drying and stimulation for breathing, about 3% will breathe after positive-pressure ventilation (PPV), 2% will need intubation, and 0.1% will require chest compression and/or epinephrine during transition to extrauterine life.1-3 One of the key factors for neonatal resuscitation is anticipation. Determining who will require resuscitation, what equipment needs to be prepared, whom to join, and how each members should participate in the resuscitation are all important factors in anticipating neonatal deterioration. Beginning resuscitation with antenatal counseling and a team briefing are also important.4,5 Heart rate and respiration are used to identify the need for neonatal resuscitation and to assess response to resuscitation. Heart rate could be checked by either auscultating along the left S62
How to cite this article: Kim AR, Kim HS, Cho SJ, Choi YS, Kim ES, Park HW, Cheon YH, Park MS, Chang YS, Kim YH, Kim DY, Yoon HJ, Kim YH, Chung SP, Hwang SO. Part 7. Neonatal resuscitation: 2015 Korean Guidelines for Cardiopulmonary Resuscitation. Clin Exp Emerg Med 2016;3(S):S62-S65.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/).
Copyright © 2016 The Korean Society of Emergency Medicine
Supplementary
Part 7. Neonatal resuscitation:
Ai-Rhan Ellen Kim, et al.
side of chest or palpating the umbilical cord base. If the heart rate cannot be determined by auscultation/palpation and the baby is not vigorous, pulse oximetry (could underestimate heart rate) or cardiac monitoring can be used for alternatives measures.6-9 Oxygen saturation determined by pulse oximetry indicates color, a third vital sign. The most sensitive indicator of a successful resuscitation is an increase in heart rate. The critical factor to achieve successful neonatal resuscitation is an effective ventilation.
NEONATAL RESUSCITATION ALGORITHM Newly born term infants who are breathing or crying and have a good tone immediately after birth should be dried and taken to the mother for routine care, with continuous evaluation (Fig. 1). However, preterm or term infants who are not breathing or crying and have poor tone should be dried and stimulated to initiate breathing, and kept in a position to open the airway effectively. It Birth
Term? Breathing or crying? Good tone?
Provide initial care (dry, warm, and clear airway)
Assess breathing, HR
Routine care
HR≥ 100/min, labored breathing or persistently cyanotic
HR
