• SDN Site Updates

    Hey everyone! The site will be down for approximately 2 hours on Thursday, August 5th for site updates.

  • How To ACE Your Medical School Interview

    In this webinar hosted by SDN with experts from BeMo Academic Consulting, you will learn a simple five-step process to help you translate your interview invitation into an acceptance.


15+ Year Member
Oct 15, 2005
Status (Visible)
  1. Attending Physician
5 components, which are graded 0 to 2. They are HR, Respiratory effort, muscle tone, reflex irritability, color (Barash table 42-4 in obstetric anesthesia chapter)
ACRONYM: SHIRT. S: Skin Color, H: HR, I: Irritability, R: Resp Rate, T: Tone

0: Absent
1: < 100 beats/min
2: > 100 beats/min

Respiratory effort
0: Absent
1: Slow, irregular
2: Good, crying

Muscle tone
0: Limp
1: Some flexion of extremities
2: Active motion

Reflex irritability
0: No response
1: Grimace
2: Cough, sneeze, or cry

0: Pale, blue
1: Body pink, extremities blue
2: Completely pink
Last edited:


15+ Year Member
Oct 15, 2005
Status (Visible)
  1. Attending Physician
Along with this goes resuscitation of the newborn...(Barash figiure 42-15 in obstetric anesthesia chapter)

Immediately after birth, the newborn should be
1. Placed supine under a radiant heater
2. Dried thouroughly
3. Wet linen removed
4. Position the head low with a slight lateral tilt
4. Suction Mouth, then Nose (Suction Trachea if thick meconium is noted or in the drepressed newborn)--No more than 30 secs
5. Provide Tactile Stimulation (Slapping the soles)

At this point respirations should be evaluated
-If patient has spontaneous respirations, eval HR. If HR > 100, eval color. If color pink, observe...If color blue provide O2
-If on initial eval pt has no respirations or his HR is less than 100, provide PPV for 15-30 secs. If respiratory depression is believed to be drug induced, give Narcan (0.1 mg/kg IV, IM, SC, or by ETT)
-After 15-30 secs of PPV, eval HR while continuing to bag
-If HR > 100, await for spontaneous respirations and then discontinue PPV and move on to evaluating color.
-If HR is between 60-100...If HR is increasing just continue PPV, if HR is not increasing commence chest compressions with PPV (3:1 or 100 compressions to 30 breaths) especially if HR < 80.
-If HR < 60...commence chest compressions and PPV (3:1 or 100 compressions to 30 breaths) for 30 secs
-If after 30 secs of compressions and PPV, HR remains below 30 bpm, initiate medications (epinephrine 0.1 to 0.3 mL/kg of a 1:10,000 solution IV or b ETT--repeat every 5 mins if necessary)
About the Ads
This thread is more than 12 years old.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.