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Additional info for Pédiatrie en maternité
Example text
Cette désobstruction des voies aériennes supérieures est secondairement complétée par l’aspiration gastrique, pratiquée en enfonçant la sonde par la bouche d’une distance bouche-ombilic. Cette dernière manœuvre peut également être responsable d’une bradycardie réflexe quand elle est pratiquée avant la 5e minute de vie. Liquide amniotique teinté Le fœtus émet son méconium dans le LA consécutivement à une exagération du péristaltisme intestinal et un relâchement sphinctérien postanoxiques. La présence de méconium dans le liquide amniotique survient dans 13 % des naissances en moyenne (7-20 % selon les séries), mais avec une concentration variable: liquide amniotique simplement teinté (LAT) mais fluide dans trois quarts de ces situations, alors que dans un quart des cas (3 % des naissances) le liquide est dit méconial (LAM) car épais, visqueux, particulaire purée de pois.
Lorsque le score d’Apgar à la 5e minute est inférieur à 7, de nouvelles cotations de ce score doivent être pratiquées toutes les 5 minutes jusqu’à la 20e minute, ou en tout cas jusqu’à ce que le score soit égal ou supérieur à 8. La règle A B C La réanimation néonatale doit être pratiquée selon les principes généraux du secourisme répondant à la règle dite ABC (Airway, Breathing, Circulation). A = ASSURER LA LIBERTÉ DES VOIES AÉRIENNES – positionner correctement l’enfant; – aspirer la bouche, le nez, et dans certaines indications la trachée; – si nécessaire, mettre en place une sonde trachéale pour assurer un accès aux voies aériennes inférieures.
Dans les cas où ces objectifs ne pourront pas être atteints, des techniques complémentaires devront être mises en œuvre.