During the gestation, labor, and birth process, infants undergo a significant amount of temporary traumatic distress. In approximately ten percent of live births, neonatal distress immediately following the birth process will require some measure of oxygen resuscitation. Of this ten percent of newborn infants, less than one percent require intensive and prolonged resuscitation to counteract the known risks of hypoxic-ischemic encephalopathy.
Hypoxic ischemic encephalopathy carries with it a high probability of permanent disability and is most commonly associated with cerebral palsy in surviving infants, while mortality is the second leading risk in these cases. Ultimately, it is the responsibility of medical professionals to immediately recognize signs indicating that breath resuscitation treatments are required and take appropriate action. Moreover, infants still in the womb can development diminished oxygen levels pre-term, and as such, this again is the responsibility of medical professionals to identify and remedy immediately, as it threatens the long-term viability of the pregnancy, as well as the long-term health of the child.
Why Infant Resuscitation May Be Required
First and foremost, infant resuscitation seeks to restart infant breathing, which has potentially ceased during the labor process. Above all, saving the life of the infant is prioritized in any non-breathing live birth situation, with primary secondary goals being preventing permanent brain damage to the child. Medical professionals should readily recognize the symptoms of an infant in respiratory distress immediately, and as such, take the appropriate action to resolve this birth crisis.
Standard of Care in Infant Resuscitation Cases
All infant resuscitation treatment is predicated on highly case-specific contexts and circumstances, with patient and mother being entirely dependent upon the immediate and emergency medical decisions-making of attending medical teams. In general, the following approaches are commonly employed as part of the infant resuscitation treatment process including:
- In a live birth, the infant is immediately placed in a warmer, inspected for airway obstructions, and provided a tactile massage to the back to stimulate breathing
- Breathing support via appropriately proportioned blended oxygen delivered via a positive pressure ventilation mask
- If required, intubation of infant via endotracheal tube may be required
- If the infant is sufficiently developed and endotracheal intubation fails to bring up oxygen saturation levels, doctors may deploy a laryngeal airway mask
- If infant is exhibiting diminishing heart rates, doctors may also use chest compressions and epinephrine to restart circulatory activity to assist with oxygen saturation in the infant
- Finally, a small percentage of cases present with meconium-tainted amniotic fluid aspiration, which presents a risk to infants and must be managed by doctors on a case-specific basis
- Additionally, in all instances, doctors must remain vigilant in post-resuscitation care and monitoring, which may entail medically-monitored hypothermia to protect the infant’s brain during this critical recovery period.
Failure of physicians and medical professionals to adhere to these treatment procedures, if applicable per a reasonable standard of care, is known as infant resuscitation error. In cases of decreased or ceased oxygen flow to the brain, time is of the essence, with permanent damage to the child probable after as little as two minutes of non-breathing.
Infant Resuscitation Error Treatment and Approaches
There are cases where physicians ignore the common signs in infant resuscitation error a situation that could lead to adverse health implications on the infant. This is because, any treatment procedure should occur immediately the problem is identified to reduce the risk of birth related complications. A small error on the part of the physicians can lead to life-threatening consequences which further reinforces the importance of immediate medical action once the problem is identified. In most cases, a prolonged oxygen deprivation on the part of a child can lead to:
- Cerebral palsy
- Permanent brain damage
- Autism
- Physical disability
- Cognitive disability
- ADD
Ultimately, infant resuscitation error treatment will be entirely predicated on the extent of the original error, as well as its impact on the oxygen levels of an infant. In most cases, the acute response will be to ensure that oxygenation levels are risen to normal levels given the weight and gestational age of the child. Moreover, innovative treatments, such as medically-induced hypothermia and other prescription drug medications, seek to preserve the brain from oxygen-deprivation trauma. However, problematically, the true impact of infant resuscitation errors and the ensuing appropriate infant resuscitation error treatment process usually is not known until the extent of the damages manifest themselves later in a child’s formative years.
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