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Effective: Summer 2011

Prerequisites: Prerequisite: RSPT 61A.
Grade Type: Letter Grade Only
Not Repeatable.
FHGE: Non-GE Transferable: CSU
2 hours lecture, 3 hours laboratory. (60 hours total per quarter)

Student Learning Outcomes -
  • Explain the steps necessary to place a newborn on an infant ventilator and applies the principles of airway management appropriately.
  • Can demonstrate the appropriate steps and sequence for the resuscitation of a neonate.
Description -
In depth look at Perinatal Respiratory Care. Examination and assessment of the neonate. Neonatal Respiratory diseases and disorders including treatment and management. Preparation for the Neonatal Resuscitation Program certification. Intended for students in the Respiratory Therapy Program; enrollment is limited to students accepted in the program.

Course Objectives -
The student will be able to:
  1. Explain the stages of fetal development and the gestational age at which they occur
  2. Identify several conditions that lead to abnormal development and lung injury
  3. Describe fetal circulation and shunts and the sequence of events that occur when the fetus transitions to extrauterine life
  4. Explain antenatal assessment and High risk delivery
  5. Demonstrate neonatal assessment and resuscitation
  6. Perform an examination and assessment of the neonatal patient
  7. Analyze radiographic studies of the neonate
  8. Interpret Laboratory data
  9. Recognize monitoring equipment and relate the data to the patient's condition
  10. Describe oxygen equipment
  11. Explain the use and indications for surfactant replacement therapy
  12. Perform airway clearance techniques
  13. Apply the principles of airway management to the neonatal patient
  14. Explain indications and use of mechanical ventilation of the neonate
  15. Explain indications and use of non-invasive ventilation of the neonate
  16. Describe neonatal pulmonary disorders
  17. Explain neonatal complications of Respiratory Care
  18. Identify congenital cardiac defects
  19. Describe Sudden Infant Death Syndrome
  20. Explain indications for Extracorporeal Life support
Special Facilities and/or Equipment -
Calculator, infant ventilators, airway care equipment, and resuscitation babies.

Course Content (Body of knowledge) -
  1. Fetal development
    1. Stages
      1. Embryonal
      2. Pseudoglandular
      3. Canalicular
      4. Saccular
      5. Alveolar
  2. Abnormal development and lung injury
    1. Pulmonary hypoplasia
    2. Hyaline membrane disease
    3. Lung prematurity
  3. Fetal circulation
    1. Stages of heart development
    2. Fetal shunts
      1. Ductus venosus
      2. Foramen ovale
      3. Ductus arteriosus
    3. Fetal directional blood flow
    4. Transition after birth
  4. Antenatal assessment and High risk delivery
    1. Antenatal assessment
      1. History
    2. High risk
      1. cervical insufficiency
      2. alcohol use
      3. smoking
      4. drug use
      5. Hypertension
      6. Diabetes mellitus
      7. Nulliparity
      8. Advanced maternal age
      9. Multiples
  5. Neonatal assessment and resuscitation
    1. Neonatal Resuscitation Program Review
    2. Resuscitation simulations
  6. Examination and assessment of the neonatal patient
    1. Apgar score
    2. Physical examination
    3. Vital signs
    4. Silverman score
    5. Respiratory assessment
  7. Radiographic studies of the neonate
    1. Chest radiographs
    2. CT scans
  8. Laboratory data
    1. ABGs
    2. Chemistry
    3. Hematology
    4. Coagulation studies
    5. Electrolytes
  9. Monitoring
    1. Cardiac monitoring
      1. arterial lines
      2. UV catheter
    2. Non-invasive monitoring
      1. Transcutaneous
      2. Oximetry
      3. End tidal CO2
  10. Oxygen equipment
    1. Fixed performance
    2. Variable performance
  11. Surfactant replacement therapy
    1. Physiology
    2. Indications
    3. Prophylactic vs. Rescue therapy
  12. Airway clearance techniques
    1. Suctioning
    2. Bronchopulmonary hygiene therapy
  13. Airway management to the neonatal patient
    1. Indications for intubation
    2. Indications for Nasal CPAP
  14. Mechanical ventilation of the neonate
    1. Indication
    2. Initial ventilator settings
    3. Modes of ventilation
      1. Pressure modes
      2. volume modes
      3. Combination modes
    4. Weaning from mechanical ventilation
    5. Alarm settings
    6. Troubleshooting
    7. Complications
  15. Non-invasive ventilation of the neonate
    1. Indications
    2. Equipment
    3. Interface
    4. Complications
  16. Neonatal pulmonary disorders
    1. Respiratory Distress Syndrome
    2. Pneumonia
    3. Meconium aspiration syndrome
    4. Tracheoesophageal fistula
    5. Congenital abnormalities
    6. Pleural effusion
    7. Pulmonary edema
    8. Cysts and tumors
    9. Malacia-Atresia
    10. Transient Tachypnea of the Newborn
    11. Cardiovascular disorders
  17. Neonatal complications of Respiratory Care
    1. Chronic lung disease
    2. Wilson-Mikity syndrome
    3. Pulmonary insufficiency
    4. Bronchopulmonary dysplasia
  18. Congenital cardiac defects
    1. Patent ductus arteriosus
    2. Atrial septal defect
    3. Ventricular septal defect
    4. Atrioventricular Canal defect
    5. Aortic stenosis
    6. Coarctation of the aorta
    7. Hypoplastic left heart syndrome
    8. Total anomalous pulmonary venous return
    9. Tetralogy of Fallot
    10. Truncus arteriosus
    11. Complete transposition of the great vessels
    12. Hypoplastic right ventricle
  19. Sudden Infant Death Syndrome
    1. Incidence
    2. Apparent life threatening events
    3. Apnea
  20. ECMO
    1. Indications
    2. Risks and complications
Methods of Evaluation -
Methods of evaluation may include:
  1. Midterm Examinations
  2. Special Assignment
  3. Lab Ventilator Check off
  4. Laboratory assignments
  5. Comprehensive Examination
Representative Text(s) -
Walsh, Brian K., Michael P.Czervinske and Robert DiBlasi. Perinatal and Pediatric Respiratory Care. 3rd ed., Mosby, 2010 ISBN 978-141602-4484
Wilkins, Robert, James Stoller and Robert Kacmarek. Egan's Fundamentals of Respiratory Care. 9th ed., Mosby, 2009. ISBN 978-0-323-03657-3

Disciplines -
Respiratory Therapy
Method of Instruction -
  1. Lecture
  2. Discussion on perinatal topics such as fetal development and birth.
Lab Content -
  1. Interpret infant CXRs
  2. Interpret clinical lab values for neonatal patients
  3. Assemble, trouble shoot and manage infant ventilators
  4. Perform a neonatal ventilator check
  5. Demonstrate how to assemble a bag/mask unit and bag a simulation baby with given parameters
  6. Performs neonatal resuscitation simulation
  7. Complete the neonatal resuscitation program (NRP)certification
Types and/or Examples of Required Reading, Writing and Outside of Class Assignments -
Reading assignments will correspond to material covered and may vary from 2-5 chapters per week.