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Okay, any on your this session? I a much organism machine chewable by two ways to go through scenarios off deliveries in any other directly on the way in the or in a teeny, it's it's zero. Surprised we do. I would imagine maybe once a year or so that babies have monster man unaware of there even for a time on whether it's unaware of it with erections, genuinely on aware of its to, never wants to base the fact but come in normal for payment on Had a liver, he goes, Had a few tragic situations where bones hopes of having a vent, whether it's traumas, car onto them or some other advantages that brain damage have been broken. The virus a station again on in, pregnant on that, anything you need it to the three and a baby. That's That's Continis down with in most situations, and it's a viral way we are. Most babies under Born are very, very much self maintaining on. There's a very, very intricate system that that case off, starting to breathe and interact and our hearts tempted to beat as they all too. And that's the situation we will want to hear the baby comes out, and this is crying loudly. Onda has a big color in a good home on Day is making a lot of noise that steps. That's the best that we could get your asses. People deal with people be's and that's that's what I'm fortunate to needs to do. A couple of things. Number one. It's important to drying the baby in newborns. Turn, turn. Is it a very, very All most of the first things we deal with more with babies for a well are mature than I think, ensuring that we keep them warm. It is almost our first pilot, and with babies with our nature, become on well on before. I make sure the every degree below a PH degrees that they are persistently bleeds to up to 20% decrease in the morning and the increasing more time for these babies subsequent. So even a warm It's important then it's a part of stimulus is well based on the border. Too noisy is to tell them down well, drying them out and very important down spikes up. Doing that once you once you drive to baby down, is to discourage that. How one of the problems that people often does. Trying a baby believe they wrapped in the wet towel or lying on the way out and which is just not good. And so if we know that they have Apple titles, But I think she used to try the baby and then and get get rid of us as 50 s possible and on then I have here just a second to go. And the other important parts for Topamax is there's tons of these maternity happen. Anything with dance on. I just called on the way back because the head is in there, but they will speech very quickly and very well, very usually on that. So having double about the other thing is being with this day still be attached to and to mom or still centam by the political court on. And that's what we have gives most here as court cops on. But normally what we do is we get two of them side by side and then put the corporate deal on. Always make sure you wear a minute because it's very And once you've done that, if the baby is born in the hospital crying and it's not reading, and that's that's acceptable. Rate is pink, and you may possibly a saturation mama for everyone to confirm that for yourself on showing Saturations Remember again the baby saturations in the early minutes of life in the first two minutes a day is low 65 a normal baby and 80 in the first five minutes and then 19. Hopefully, after after 10, and the other thing we do with babies and the baby comes out screaming, you don't begin to do this so much. But in smaller babies, babies familiar are in trouble because with the cold air score now this this is a named after a American pediatrician called Virginia Car. But we also find a way between, like a pregnant. So a is is there is appearance on it for each bring to the score from somebody at our school, we give. As for the the 01 or two and understanding So the worst zero on the best of the 10 Oh, I think more on the position that any other reason you tend to get them at ours. Attendants who denying for whatever reasons and so the appearance is, is whether they're blue are the blue completely balance and physical zero. And if they're painful with groceries because most babies are, they get themselves of one. And then if he's going to at home on the and you get a zero or no ulcer or less than 60 on anything, about 100 will give you that. I'm sorry, but the pulse you get a 00 pulse on one for next 102 for over 100 on. Then thing grimaced. So when you suction the baby's nose, which is the baby was already crying and active. You don't have to do, and it's such a baby's nose is ear. Oh, is no response. One is a slight response, and two is, but, um, it's an off, even cry and activity band is the fourth, and activity is are nice and flex the movement. Moving an active make those legs has like to see with these babies on, like that's your two. Are they somewhat active? A little bit of a problem that's detectable. That's the one on and they completely destroyed copy and that's That's a zero on then. Finally, the our our score is spiritually efforts so again, if it's no respiratory effort to get a 01, respectively. Look at the summer, spiritually past the one on. Then they bitch going reading. They get a guess to get to. And so generally you give your score than that. One minute. I'm fine with that. Same, but they need all million potentially could take that for. So that's the normal baby. That's the baby at this point with. This baby is nice and dry and trying and even that up nicely in the blank of the handles. Mom can as skin to skin time, possibly and or are you going to breast? Okay, so So, as I said, is the vast majority of cases of the best in your case is biggest. Will, Will will appear like this, crying well, mostly on, but no real significant intervention from you. It might be useful to obtain just just using a straightforward and blood gas syringe able to obtain was doing a Zocor gas and to know what it was. Just paste. Sometimes if they're being a previous history of it, the big picture of coming in with no fear and I have what was happening before the baby was born and it might be disposed it just to get a court gauge, which can be a useful thing. Turns out for the baby was actually score stressed in there, so on. And that's the normal baby. And then Okay, so I'm just going to pull up the next on second video. Then, as I said, the majority of babies will be normal and crying when they're born and close you any any motion of then then going to see the newborn baby because you love to do Okay, surely Maybe will be born. What we refer to click will really have splats. So the baby will be born with no respiratory effort that before the last course for on be sloppy they, you know here to be to be breathing and the steps for resuscitated this baby on the same steps is in both as as as in any other way, to follow the a b c d. It's important. And you received the baby. As I said initially, first we could put a t of beginning of the TV, but he basically said the temperature's going to explode in the warm in the term. Baby, you driving them often. The that stimulus itself is enough to start breathing, and but you dropped trying down. Get rid of the town, put them in an area that's nice warm. It's important to keep these Vegas warm in our situation because we're trying to resuscitate from downstairs and have a baby that probably fitness to want to move. And but at that point, you still trying to. Actually, it was a warm is your toe on you, then assess the baby. And again, it's the best way to assess is that your ladies heartbreak is using instead of smoke. It's quite difficult to find the post of the not particularly reliable. The full dose is on on a M. Something about using that, the lightest complected just dealing with the Enbrel, Um, on in that, that's what you can feel a possible that's not terribly reliable after below 100. And so listen and see what the pulse is at. First important thing, though you want to do with this baby is not making any respiratory breaths in a thing that we refer to. That sensation breath in this situation is being born and was commendable and hasn't crying hasn't taken a deep breath, and they're they're they're still sort of unusual, so it is still taking class. And so they're having a difficulty again in an expanding them and breathing. So what you want to do that is do that for them and infection breaths. Don't usually upstairs. Use a thing called closing cough. Which Kansas? For this, a fire off Aaron. It's important to use a rescue and no baby. The oxygen pure oxygen 100 sandals is very tempting in the Maybe it was blue and all the rest, but it's not caused damage and a serious of difficult and systems, particularly I beyond but also various other organs of base. So what we do is institute liver and facing brands I like to use other and a mold of off delivery pressure and pulse as sensitive eighties airway and making sure that there's not been blocking the airway stocking out necessary on putting the baby's head impulsive for towards the neutral position. So it's normal already extended and start over effects on being a number of situations. Describe this emergency because something back dating with the time that you get no where we're total is a little bit, and that's from the Utah position on then with your your your pants, which temperature you could have a proper you mentioned ask is, is is put on my eyes and the other you can in these situations is necessary. Use on the Abbott Mass and making sure that you get a good seal of that covers in time. Facebook About. But in the in most situations which could do is give your your baby mask. Get a good seal on, then with the every class and open delivery. Pressure is nice and good long brand. So it's not on both papers from the best place in babies vaginally. Nice short breast because they quickly in this situation, it's with a degree of pressure. So you get a good question. So much time it was. Open up the baby's lungs on you want to get a visit? Three. Satin bones was three good pressure, and you're doing this. Watch the baby quite frequently. You just take one or two and get up to sign. A refer to is, um, patient breaths on hopefully gamble situations like this that you will then begin to crying, gets reacting on. I'm just going for you in some situations where you have to continue, then you have to continue on with the insulation breaths, going 60 per minute, and that's such a time. Then you will go into a culture. And when you got your your your your breathing been the breathing for them is necessary. Then you put this into the heart. When we listen to the baby's for efficient here, he wants to hear heart it off 100. And if it's less than 60 this is when you begin to do your CDL, the CP or some in two different ways with Children. And that depends largely more babies depends on how many you have with you. And if you have a number of other people, you get something to do this testing and that certainly medicines I think, is the best. Um, I'm basically in most putting in both hands around the baby's chest, hosting your your your funds and let's turn, um, and then with the same way, wouldn't hurt of the chest. And you, you you depress the baby and you get pressure comes by a third of the greatest of the chest, and then you you you keep doing that, providing the invents, literally bath dress on usually one on our aspirate of one every three on the compressions, which is different than than an anastomosis wish. Newborns. And it's one every three compressions that she had to give the best place to regress. So at this point at way with Pope and then in the vast majority of babies, they will begin to come around. Sometimes it's a little vial of little bit of tension lately breaths, but usually wants to be drops. You know, the baby stream to see the aura through a bad class and ventilation there would be into to obsolete, and we'll begin to toe, broke up and respond for you and occasionally babies who are in question advanced state of hypoxia. They had three of the 20 and you don't have the delivery of base of the 90 degree on the or basically my prior to delivery, and that these babies name eat, become quite as a doctor, and they have been quite well, and the the off intervention this is this is continue to enter your CP or hopefully at that point, you have one of us down here Thio, and we'll be able to do and those things by play off them in a T tube of necessary on a gel mask on, then being this access, usually with babies. We have one great advantage with these for for getting this answers and that is there on the line, a switch in situations, but it's it's required and reasonably easily be evaluated with a catheter and b. You supposed to throw that initially and then for the taste of it, all right, if we do get a lot in that situation, we have any UPC you get from other sources. But with our say you DC, it's very important and these babies, but it's going to be getting more important. Is it for more mature and to get a sugar? One of the big differences between a baby who is born at less than two weeks and of age is on the term is the presence of a lot of fat and also off estrogen liver. So small, premature babies. They have a basket very, very quickly, and what you're doing with this very much stressing going on that's going to increase the risk of progressing so theophylline thing that might happen in the baby whose was delivered at a You know, they're saying the onions on the way in the war, unexpectedly in, in at the thing the emergency department can be at the presence of meconium. In about 10% of all there is, there is some a call you Is that the bowel contents of the baby and his Hans usually. And if the bank is stressed in normal liver eczema for is a bit meconium off of the babies have has been delivered, and that has been brought down in the house. And the baby hasn't been gasping unusual. So natural Fact the meconium isn't so much of a concern. And accept is an indicator that that might be a bit stressed in some situations. That may be a lot meconium on. Get that situation. You, at the risk of colon aspiration syndrome released. Very, very, um, little babies for my physicals to two at two. To manage. It is a There is a law only, um, it used to be the requirement that such a suction there are mountains on the constable balance. And, um, apparently, uh, before they were for the liberty Now we say, Don't do that. It doesn't help on. But if the baby then and is having difficulty having this, for instance, use into mutation rebranched vaccination, rest of the state. Hey, it may in fact be that you do. At that point, I have a pony in any end. Yes, and you have a look down on such snap on. You get that. Some people get so big attrition. Do it. So when you're on the Aspiration syndrome is a little bit beyond the scope of this scope. It it leads to very nice around my babies. Another scenario that that kind of car is on the port. The end of the pregnancy pills at the center is whatever raising comes away from the the uterine wall and conditional nous as central abruption. This is an eternity emergency and offset emergency on the on. The The baby needs to be delivered. It's quick. It's possible. Sometimes Mom is already in advance flavor of it. Ways to deliver the baby, a vaginal e On the that situation, we need immediate assessment. I have one funds been in the situation, but because of the abrupt from the baby has lost significant amount of but on the situation you get. IV access is quickly as possible on get all negative blood into the stadium, just as as quickly as possible in the inhaler to save your life. It's it's It's a significant emergency in the initial scenario, and certainly, if there's any suggestion off tensile abruption, you have a consult pediatrician there and as quickly as possible, another. The initial emergency. Although it's something open, things happens from chair spend with your eyes examined. The mother of the time that she has supposed to court cold outside occasionally come over cells. Who knows that cord is has to China and that situation again on the baby. Just the general rule is that if you if you think that might be a cortical upset, they speed maternity as quickly as possible delivered. That's quick, sometimes maybe delivered, delivered early or coming. Surely they there's of someone arbitrary couple of days or 32 weeks given, and for extreme prematurity as opposed to primary surety, which is the impression sure is an extreme prematurity is they do need immediate on a skills in Africa, immunity with air on in the more extremely premature world's be getting a tricky um, so there's going to be in a script as possible. And the administration of surfactant is has made an enormous difference difference to these papers lying in general, the latest sky instead of getting from the the The nasal cessation is that we should be giving these babies a chance from anything as earliest 1 to 2 weeks on. But a baby born in any 22 weeks probably doesn't have an awful chance that needs to be really to be in a place where they can be immediately intubated. Advance later. So fax it administered and then and I mean fluids. And I forget. The name problem with these small babies is that their brains are a bit about the brain. Just kind of a very fine network of capillaries on these babies are born born prematurely that has sweeping changes, the BP or high and then very low, which determine its to them. Having damaging these recently in the rain. On these things get into problems with cranial hemorrhage, which could be a major problem on, but it's a lady for very good insurance. There needs to be in special very picky. You know, it's possible in a situation where this might happen. Certainly keeping warm is important that you have already to the extent that that on well, is, we do a very good crunch. A baby's delivered a plastic bags on which, actually dramatically decrease is that he lost because mostly classes from evaporation and and from conviction on the basis small print your Valium, who weighs seven with France and lose a number of reasons temperature from from a mom at over to the services the tax form on. Um, But again, this is something where you're using your pft been urinating college will need to be involved. Okay. Thank So what? Sure. Mike, um, you know, the question is just straight off the bottle for make there or yeah, we haven't had very many questions to a farm like today, so, you know, you get away with, but really get just to see that kind of an option, because I think this is the presentation that probably from moves footwork on any. This is the real heart like and situation so and that you're just hoping you've got someone Hyundai that really didn't. So it's really the best amount of babies. As I said, our self starting so so on. More more babies or even being book born at home. So So it's It's, um, it shouldn't be too much of a heart stent Put in deed. A sick newborn can be a major major problem. Yeah, absolutely. And we questioned from Carl says, Do you ever consider ocean via Bible Mask and the natural resource he's pre term? More and more nowadays, the tendency is to to use just a Rabasa ble. Um, there is there is an algorithm off increasing the amount of option of more on the more extreme premature ones. You might start with 30% and but certain term babies you're you're looking at at room Air O. R. A low concentration of oxygen. And even at that, that would be later in the resuscitation. And by and large, as I say that there's more more evidence showing that that 100% oxygen can be quite damaging to babies. Most of the neurological tissues, such as as the eyes on brain on do we do. We do try and steer away from from high concentration. Thank you. Any other questions for her. Like what we've gotten. Not she. Okay, great lines. Things so much for doing that for us. Thank you. Been a pleasure. Thank you. Any time. Okay.