Question

You are on-scene assisting another crew with a childbirth call that quickly turned into a neonatal resuscitation. The newborn does not have a palpable brachial pulse, but muffled heart tones and the monitor confirm a sluggish heart rate of 55 beats per minute. After reassessing him after a few minutes of high-quality chest compressions and effective ventilations with 100% oxygen concentration, the patient's heart rate fails to respond.

Which of the following would be considered a class IIa intervention for this patient?

A. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route

B. 0.01 mg/mL of a 1:1,000 concentration of epinephrine delivered via the intramuscular route

C. 0.25 mg/mL of a 1:1,000 concentration of epinephrine delivered via the endotracheal tube route

D. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered intravenously

Answer 1

The most appropriate class IIa intervention for a newborn requiring resuscitation with a low heart rate is 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered intravenously.

Step-by-step explanation:

The appropriate class IIa intervention for a newborn with a heart rate of 55 beats per minute that fails to respond after high-quality chest compressions and effective ventilations is 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered intravenously. When a brachial pulse is not palpable, and chest compressions are not effective in increasing the heart rate, intravenous (IV) or intraosseous (IO) access is critical for drug delivery. The recommended dose of epinephrine in neonatal resuscitation is 0.01-0.03 mg/kg of a 1:10,000 solution. The intramuscular route is not typically recommended for resuscitation in neonates.