Pulmonary Care 6

In addition to establishing and maintaining the artificial airway, the clinician must demonstrate a working knowledge of the multiple supportive pulmonary care skills that are essential for optimal care of the intubated and ventilated neonate. This chapter presents the principles and guidelines required for the safe intubation and successful pulmonary care of these critically ill infants. Some of the guidelines addressed will reflect significant changes in cardiopulmonary resuscitation (CPR) of the newborn presented in the revised Neonatal Resuscitation Program (NRP) (see Chapter 4). With the “explosion” of new information available regarding the care of the neonate who requires assisted ventilation, we attempt to focus the discussion in this chapter on pulmonary care. The reader will be referred to other chapters of the book for a more indepth presentation of specific topics. All caretakers involved in the management of these babies need to be aware of the safety issues with regard to the transmission of pathogenic organisms by bodily fluids and closely follow the Occupational Safety and Health Administration (OSHA) standards outlined in Appendix 30.