DEFINITION: Progressive hypoxia, acumulation of CO2 and acidemia CLASSIFICATION: Without asphyxia (APGAR score 8-10) Mild- moderate

(APGAR score 4-7) Severe (APGAR score 0-3)

Pre/intra natal : Placental insufficiency Post natal: secondary of lung insufficiency heat disease

Gambar no 5

Place under radiant heater Dry thoroughly remove wet line Position Suction mouth then nose Tactile stimulation None or gasping

Evaluate respiration Spontaneous < 100 x/m

PPV-O2, 100%, 15-30

Evaluate Heart rate > 100 x/m pink or peripheral Black cyanosis observe and monitor O2

Evaluation heart rate

< 60 x/m - Continue ventilation - Check compression

60 - 100 x/m HR not increasing - Continue ventilation - Chest compression if HR < 80 x/m HR increasing - continue ventilation

> 100 x/m Watch for Spontaneous respiration Then discontinue Ventilation

Initial medication if HR < 80 x/m, after 30 PPV - 02 100% & Chest compression

 HR zero or HR below 80/min after 30 seconds PPV and chest compressions

Give epinephrine

May be repeated every 3-5 minutes if required

HR above 100 ?

Yes

Discontinue medication

No

Prolonged are that does not response to other therapy Give sodium bicarbonate

Evidence or suspicion of acute blood loss with signs of hypovolemia Give volume expander

May be repeated if signs of hypovolemiapersist

Evidence of continuing depression ?

Consider other caused, eg. - Pneumothorax - Diaphragmatic hernia - Persistent pulmonary hypertension Consider stating dopamine Consultation

Intrapartum suctioning of mouth, pharynx, and nose

Thin

Thick

Infant active Observe Resuscitate PRN

Infant depressed Suction trachea Resuscitate PRN