As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats per minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care?

Question

Quizplus · Accepted Answer

Attempts to suction meconium from the pharynx or trachea before birth, during birth, or postpartum increase the likelihood of severe aspiration pneumonia. Some obstetricians perform oral and nasal suctioning on meconium-stained infants after delivery of the head but before delivery of the shoulders. However, a large, multicenter, randomized trial showed no benefit from this practice. Therefore, current recommendations for infants with meconium are that (1) no intrapartum suctioning should occur; (2) infants who are vigorous at birth (strong respiratory effort, a heart rate of greater than 100 beats per minute, good muscle tone) should not receive tracheal suctioning; and (3) infants who are not vigorous (no or poor respiratory effort, a heart rate of less than 100 beats per minute, poor muscle tone) may receive direct laryngotracheal suctioning.

As the Head of a Neonate Contaminated with Meconium Emerges