Dhulikhel Hospital Kathmandu University Hospital
3rd NEONATAL LIFE SUPPORT (NLS) COURSE IN DHULIKHEL HOSPITAL NEPAL 2018

A one day course in Neonatal Resuscitation

Collaboration with University of North Tees and Hartlepool sponsored by Health Exchange Nepal (HExN)

NLS courses held Third time in Nepal at Dhulikhel Hospital, Auditorium Hall, Kathmandu University Hospital collaboration with University Hospital of North Tees (UK) sponsored by Health Exchange Nepal (HExN) and is for junior doctors, neonatal nurses and midwives who need to learn the basic skills of neonatal resuscitation. The NLS course is base on resuscitation council (UK)which includes lectures on physiology in resuscitation at birth, skill station in airway management, vascular access (Umbilical catheterization) cardiopulmonary resuscitation (CPR) with modern simulation Those experienced in resuscitation who wish to certify as providers and possibly go on to become instructors also wish to attend. NLS course is endorsed by Nepal Paediatric society (NEPAS) and accredited by Nepal Medical Association (NMA).The course is being held on:
27 or 28 June 2018
The cost: NRs 1000/- for all candidates inclusive of manual, lunch and refreshments.
You should receive your course manual and programme during registration or directly download from our hospital web site www.dhulikhelhospital.org . The certificate will be awarded after completion of evaluation of Pre-Test and Post-Test.

Contact: Dr. Narayan C. Shrestha
NLS Nepal Co-ordinator
Email: nara650@hotmail.com
Mobile No: 9841348022
To reserve a place on the course please complete the application form and return to: Dr. Narayan C. Shrestha Consultant Pediatrician Dhulikhel Hospital (nara650@hotmail.com)


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Organization *
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Pre course questions:
1. A tracheal tube can be used as a suction catheter. *
2. The Apgar score correlates well with the degree of foetal acidosis (i.e. as determined by the umbilical cord pH and base excess) *
3. The baby should be weighed to ensure that drug doses are accurate *
4. Opening the alveoli in an apnoeic, unconscious newborn baby requires a positive pressure of 15-30 cm water *
5. Therapeutic hypothermia is of proven benefit in asphyxiated preterm babies *
6. In the severely compromised baby requiring resuscitation, boluses of fluid should be given only cautiously. *
7. Babies in primary apnoea can initiate breathing themselves if they have a clear airway. *
8. Resuscitation (i.e. ventilation and chest compressions) of newborn babies is a common event. *
9. The ‘assisted transition’ and stabilisation of a preterm baby follows a standard A, B, C approach. *
10. The initial assessment of an apnoeic baby cannot predict the extent of resuscitation required. *
11. An incorrectly sized oropharyngeal airway can, in itself, cause blockage of the airway. *
12. Peripheral intravenous access is a safer and equally effective alternative to umbilical venous access. *
13. All babies born through meconium stained liquor will have inhaled enough meconium for this to cause problems. *
14. Once the heart rate falls to about 60 min-1, it is maintained at this rate by aerobic metabolism. *
15. Most children who are later diagnosed with cerebral palsy had a low Apgar score (less than 7) at five minutes. *
16. Most newborn babies have to be stimulated to make them breathe. *
17. All babies with meconium stained liquor must be intubated. *
18. Agonal gasps occur at a rate of 30 per minute. *
19. Cord blood pH measurements can be made from double-clamped umbilical cords up to 60 minutes after delivery. *
20. The correct position of the head in newborn resuscitation is described as “sniffing the morning air”. *
21. Mask inflation commonly causes pneumothorax. *
22. Breathing stops in 2-3 minutes if the brain is deprived of oxygen. *
23. Healthy term newborn babies are able to clear more than 100 ml of fluid from their lungs and airways without help. *
24. There is good evidence that giving adrenaline (epinephrine) via the endotracheal tube is effective in resuscitation at birth. *
25. A newborn baby who is apnoeic should be given naloxone immediately *
26. Additional stimulation of the baby by flicking its feet is beneficial. *
27. Oropharyngeal airways are not used in newborn resuscitation *
28. An Apgar score of 3 at one minute predicts severe neurological damage *
29. Carbonic (HCO3-) and lactic acids accumulate if the umbilical cord is obstructed before the baby is born. *
30. If baby is delivered through thick meconium and is floppy and unresponsive, you should examine the oropharynx, and be prepared to suck out any particulate matter, before aerating the lungs. *
31. Oxygenation can be accurately assessed from the colour of the baby. *
32. The apnoeic baby who gasps in response to resuscitation is most likely to have been in primary apnoea. *
33. Pulse oximetry is a useful tool in managing preterm babies. *
34. Hypoglycaemia should be corrected using 50% dextrose. *
35. Babies born before 25 weeks gestation should not be resuscitated. *
36. The shape of the newborn baby’s occiput has no effect on resuscitation. *
37. Without intervention, the physiological outcome of terminal apnoea is for the baby to die. *
38. The placenta should be retained for further examination in cases of prolonged resuscitation. *
39. Crying after birth may generate a greater ‘negative’ intra-thoracic pressure than the positive pressures recommended during newborn resuscitation. *
40. Gasping begins immediately when normal breathing stops. *
41. Glycogen is an essential fuel source during fetal hypoxia. *
42. Intubation is essential for effective resuscitation *
43. Agonal gasps are shallow. *
44. The first sign of effective resuscitation is an increased heart rate. *
45. Initial lung aeration (inflation) should be at a rate of 30-40 per minute. *
46. Continuous Positive Airway Pressure (CPAP) is useful technique to support the breathing of the very preterm baby. *
47. Structured communications tools (e.g. SBAR) help impart important information quickly and effectively. *
48. The depth of chest compressions is 1/3 of the antero-posterior diameter of the chest. *
49. Sepsis should always be considered as a possible underlying cause of peri-partum hypoxic events. *
50. The recommended compression to ventilation ratio is 3:1 at a rate of 120 ‘events’ per minute. *
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