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About Lama

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    American University Medical Center
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    Beirut, Lebanon

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  1. This has been addressed by WHO.WHO recommendations: If no spontaneous breathing after 20min of adequate ventilation, continue for 30min while preparing for transfer to NICU OR Discontinue if no NICU care available. See WHO web site on neonatal resuscitation guidelines.
  2. Another measure can be taken after intensive triple phototherapy, in case of hemolysis adn before exchange transfusion is giving IV IG 0.5g -1g/kg over 2h (Subcommittee on Hyperbilirubinemia, Pediatrics 2004;114:297-316). A useful tool on the net is www.bilitool.org: you plug in the serum bili level, the age of the baby in hours and you get suggestions on what to do....
  3. I happen to be an NRP regional instructor and I asked this very specific question to the NRP officials via email. The response I received, which for me makes sense, is there should be a policy in each hospital on which guidelines to use and where depending on the setup of the hospital, the staff education and their comfort level doing resuscitation using NRP or PALS recommendations. Bottom line, outside the delivery, and until new eveidence, you do the best you can with the method you feel you are most skilled.
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