apnea : failure to take spontaneous breath for 10 seconds or long enough to produce cyanosis or bradycardia
ddx :
1-respiratory : respiratory distress , intrapulmonary pathology
2-cardiobascular : hypo-hypertension , anemia , heart failure
3-cns : immature brain , kernicterus or hemorrhage
4-git : oral feeding , esophageal reflex , intestinal rupture
5-infection : sepsis or meningitis
6-metabolic : hypoglycemia , hypocalcemia , hypoxia , fluid and electrolyte disturbance
7-idiopathic : immaturity of respiratory center , deep sleep
MANAGEMENT :
ABC , RBS
auscultate the heart beat :
if tachycardia and apnea = seizure (treat as seuzure )
if bradycardia and apnea = cardiopulmonary arrest ,start cpr :
central chest compression by two thumbs (100 compression per min) then after each 30compresison give 2 effective ambu-bag breath after lifting chin and tilting head (30:2compression:breath) if you have assistant 15:2
give aminophylline bolus dose 5mg/kg diluted with G/W iv , adrenaline amp iv (inject 20cc N/S after give adrenaline)
continue cpr and perform cutaneous respiratory stimulation by spinal and sternal massage , striking the lateral thigh and the buttock