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Your team has provided face-mask PPV with chest movement for 30 seconds. When is placement of an endotracheal tube strongly recommended?

a. The baby's heart rate remains less than 100 bpm and is not increasing.
b. The baby's heart rate is between 60 and 100 bpm and the heart rate is increasing.
c. The baby's heart rate is >100 bpm and the baby is beginning to breathe.
d. The baby's heart rate is >100 bpm and oxygen saturation is less than the target range.

User Aleadam
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Final answer:

An endotracheal tube is strongly recommended if a baby's heart rate remains less than 100 bpm and is not increasing after 30 seconds of PPV with chest movement. The need for such intervention may be guided by the Apgar score, which indicates heart rate and respiration as critical markers for a newborn's condition. The normal respiratory rate for infants also provides context for evaluating a newborn's condition post-delivery.

Step-by-step explanation:

Placement of an endotracheal tube is strongly recommended when a baby, after receiving positive-pressure ventilation (PPV) with chest movement for 30 seconds, has a heart rate that remains less than 100 beats per minute (bpm) and is not increasing. In such a situation, the baby may not be receiving adequate oxygenation and may require more advanced airway management to stabilize their condition. According to the Apgar score, a critical tool for assessing a newborn's health immediately after birth, heart rate and respiration are the most critical parameters. The Apgar score can guide healthcare providers in determining the need for immediate medical intervention such as intubation.

For instance, during APGAR scoring, a total score below 5 indicates an emergency situation that could justify tracheal intubation. In addition, it's important to consider the normal respiratory rate of a child, which varies with age. A child under 1 year old normally breathes between 30 and 60 times per minute, while a newborn's first breath can significantly alter circulatory patterns, marking an essential transition from fetal to neonatal circulation.

User Ashish Awasthi
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