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Discussion

Crash C-Section Interventions

Hello,

I would like to learn more about what NICU nurses typically do for a newborn in a crash c-section or your observations of what mother receives if she has complications during the delivery.

I haven't had much exposure to risky deliveries. Apart from drying the baby, taking vitals, cutting the cord, providing oxygen, cpap, or intubation, what have you done in an emergency situation?

Can you provide examples? If you have ever given epinephrine, what was the reason for it? (nucal cord etc?)

What interventions have you observed with mothers who are crashing?

Thank you!

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    • Expert

    This is covered in Neonatal Resuscitation Program. All nurses working in L&D, Nurseries, and Post partum must be certified in this program and re-certified annually.

    Neonatal Resuscitation Program - Home

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    I've done ACLS (in the past) and NRP currently. NRP is far simpler because short of congenital anomalies, there are usually just a couple of etiologies at work in the depressed infant in the delivery room. Respiratory support almost always does the trick. As will be clear in the NRP program.

    Sorry, don't know anything about the maternal side.

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    • Expert

    It completely depends on the reason for the crash. Sometimes they are crashed for reasons that mostly affect baby (say, a dropped cord) , other times for things that more immediately affect mom (say, pre-e). Occasionally you will get the crash that affects both (say, abruption). As the baby nurse at that delivery, I'm going to anticipate more involved resus with a dropped cord or an abruption than I would for pre-E (obviously depends on gestation, but let's assume term).

    Mom will sometimes get general anesthesia (if she doesn't already have an epidural) for a crash c/s, which presents an additional risk for the baby. Most of the time they just need a little O2 and tincture of time as the anesthesia works its way out.

    Abruptions will sometimes need blood, esp if it's a big one, but it's not something I've seen done in the DR/OR.

    As previously state, most resus will revolve around respiratory issues, and even most crash babies end up needing very little beyond the usual stim.

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    "Tincture of time," ha. I like that, not heard that one before.

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    • Expert
    "Tincture of time," ha. I like that, not heard that one before.

    My great-grandma used to say it.....works well in a lot of contexts. :D

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