Infant airways and decels

[jennf83]

Two questions here..I just started a new job in labor and delivery and they were showing me how to check the infant warmers. We were going through all the equipment and came across these little plastic pieces that were infant airways. I was wondering how they are used, noone really explained them to me and during nnrp they never were even brought out.

My next question is about decels. Our pt was having decels, I thought they looked like lates, they were occuring after the peak of the ctx, with every contraction. They werent "subtle" like the lates I have seen. My preceptor said they were variables, but to me they didnt really look like the variables I have seen either, so I was wondering if variables can appear as lates or vice versa. They didnt look v-shaped, they kind of looked like a mix between a variable and late, so wasnt sure what it exactly was. Thanks!

[Jolie, BSN]

And you can attach an ambu bag to that kind of infant airway? I never took notice.

No you use the mask over the baby's mouth and nose with the airway in place.

[CEG]

A late decel will start after the apex of the UC, and will return to baseline after the end of the UC. They can be subtle or deep. They are usually spoon-shaped, but not always. Yes, variables can have a "late component" to them.

As far as what the "little plastic pieces" are - you got me.

New NICHD terminology has clarified the definitions and changed some of this. There are no longer variables with a late component. Here is a brief snippet from: http://www.nccnet.org/public/files/NICHDMonograph.pdf

LATE DECELERATIONS

Based on visual assessment, a late deceleration is

defined as an apparent gradual decrease in fetal heart

rate and return to baseline associated with uterine

contractions. Onset to nadir is equal to or greater

than 30 seconds. The nadir of the deceleration occurs

after the peak of the contraction.

EARLY DECELERATIONS

Based on visual assessment, an early deceleration is

defined as an apparent gradual decrease in fetal heart

rate and return to baseline associated with uterine

contractions. Onset to nadir is equal to or greater

than 30 seconds. The nadir of the deceleration occurs

at the same time of the peak of the contraction.

VARIABLE DECELERATIONS

Based on visual assessment, a variable deceleration is

defined as an apparent abrupt decrease in fetal heart

rate below the baseline which may or may not be

associated with uterine contractions. Onset to nadir

is less than 30 seconds. The decrease in fetal heart

rate below the baseline is equal to or more than 15

beats per minute, lasting 15 seconds or more but less

than 2 minutes in duration from onset to return to

baseline. When variable decelerations occur in

conjunction with uterine contractions, the onset,

depth and duration vary with each succeeding uterine contraction.