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A newborn has just been delivered. He is limp with central cyanosis, and his mouth and nose have thick black secretions. What should you do?

a. Suction with an endotracheal tube and direct laryngoscopy
b. Suction the mouth, then the nose with a bulb syringe
c. Suction with a French catheter and insert an oropharyngeal airway
d. Suction the nose, then the mouth with a bulb syringe

Answer :

Final answer:

For a newborn who is limp with central cyanosis and thick black secretions, suctioning the mouth then the nose with a bulb syringe is the appropriate initial step. This action prevents aspiration and potential complications such as meconium aspiration syndrome.

Explanation:

When faced with a newborn who is limp and demonstrating central cyanosis with thick black secretions, immediate action is required to clear the airways and support the newborn's first breaths. The correct course of action is suction the mouth then the nose with a bulb syringe. Clearing the newborn's airways in this manner is critical, as it helps prevent aspiration of meconium, which could lead to labored breathing, respiratory obstruction, and potentially severe pulmonary complications. It is essential to prioritize suctioning the mouth before the nose to avoid pushing any obstruction deeper into the airway.

In the scenario described, the newborn's symptoms could suggest meconium aspiration syndrome (MAS), a condition where meconium is present in the lungs, which can follow if the baby inhales amniotic fluid mixed with meconium before or during delivery. Early intervention, such as suctioning as described, can help reduce the risk of MAS and its associated complications, highlighting the importance of rapid and appropriate newborn care immediately after birth.

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Rewritten by : Barada