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  • Dr. Kaitlin Dupuis MD CCFP

Two memory tricks to help you recall NRP

SHORT ANSWER MANAGEMENT POP QUIZ:

  • According to the 2015 AHA guidelines, how long after birth should the cord be clamped if a cord avulsion is noted?

  • Which THREE features should be assessed immediately after birth to determine if a newborn requires stimulation?

  • List FIVE immediate interventions for a newborn that is born with poor tone.

(Answers are in the blog post below or the linked NRP guidelines.)

Attending a delivery to care for a newborn who may require resuscitation at birth is sure to make your pulse go up - keep your cool by remember this mnemonic for babies that require further intervention after your initial assessment.

TRICK #1 - TONE / TEARS / TERM

Ask yourself:

TONE – is baby moving all four limbs vigorously?

TEARS – does baby has vigorous cry (no grunting or indrawing)?

TERM – is baby is greater than 37 weeks gestation?

If you answer “YES” to all three, baby can go with mom! Provide routine care.

If you answer “NO” to any of these, the following interventions may be required:

- Stimulation

- Free flow O2

- Positive pressure ventilation

- Chest compressions

- Medications

TRICK #2 - BREATHING / BEATING / BLUE

When the baby comes out, just keep repeating in your mind “BREATHING? BEATING? BLUE?”

This will help you remember:

BREATHING? If not, do something! Reposition, stimulate, or provide PPV.

BEATING? Check the pulse! Remember the thresholds from NRP – your actions are different if the pulse is < 100 or if it is < 60 bpm.

BLUE? If you see cyanosis, act! Provide oxygen and consider CPAP.

Sources:

https://eccguidelines.heart.org/wp-content/uploads/2015/10/Neonatal-Resuscitation-Algorithm.png

http://www2.aap.org/nrp/docs/15535_NRP%20Guidelines%20Flyer_English_FINAL.pdf

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