Neonatal Asphyxia Course

Lesson 1 • Global Epidemiology and Burden

Presents incidence, mortality, and morbidity data across high- and low-resource settings. Contextualises why prevention and early intervention are critical priorities.

Lesson 2 • Fetal Physiology and Oxygen Delivery

Reviews normal fetal oxygenation, circulation, and metabolic demands. Establishes the physiological baseline needed to understand how asphyxia disrupts homeostasis.

Lesson 3 • Definition and Classification

Covers precise clinical definitions and grading systems for neonatal asphyxia. Provides the conceptual baseline for all subsequent diagnostic and management content.

Lesson 4 • Etiology and Risk Factors

Identifies antepartum, intrapartum, and neonatal contributors to asphyxia. Enables learners to stratify risk before and during delivery.

Lesson 1 • Intrapartum Electronic Fetal Monitoring

Teaches systematic interpretation of cardiotocography tracings during labour. Builds on fetal physiology knowledge to explain pattern origins.

Lesson 2 • Fetal Scalp Sampling and Lactate

Introduces invasive adjunct tests for confirming fetal acidosis when monitoring is equivocal. Provides decision thresholds for clinical action.

Lesson 3 • Documentation and Communication of Findings

Establishes standards for recording surveillance data and communicating concerns to the team. Accurate documentation supports medicolegal accountability and handover safety.

Lesson 4 • Antenatal Fetal Assessment Tools

Covers biophysical profile, Doppler velocimetry, and non-stress testing. Connects each tool to specific risk scenarios identified in Chapter 1.

Lesson 1 • Initial Assessment: The First 60 Seconds

Teaches the rapid evaluation sequence applied immediately after birth. Connects assessment findings to the decision to initiate resuscitation.

Lesson 2 • Identifying Asphyxia at Birth

Integrates assessment data to confirm or exclude significant asphyxia. Prepares learners to trigger the appropriate management pathway immediately.

Lesson 3 • Preparation of the Delivery Room

Covers equipment checks, team roles, and environmental setup before high-risk deliveries. Preparedness directly reduces response time when asphyxia is present.

Lesson 4 • Apgar Score: Scoring and Limitations

Explains Apgar scoring methodology, timing, and clinical utility. Clarifies what the score does and does not indicate about asphyxia severity.

Lesson 1 • Positive Pressure Ventilation

Provides detailed instruction on bag-mask ventilation technique, rate, and pressure. Effective PPV is the single most critical resuscitation skill.

Lesson 2 • Stimulation and Drying

Teaches tactile stimulation methods and their role in initiating spontaneous breathing. Connects stimulation response to the decision for further intervention.

Lesson 3 • Airway Management and Positioning

Covers head positioning, suction indications, and airway opening manoeuvres. Correct airway management is the first active step in resuscitation.

Lesson 4 • Chest Compressions and Medications

Covers indications, technique, and coordination of chest compressions with ventilation. Includes epinephrine and volume expansion as last-resort interventions.

Lesson 1 • Respiratory Support Strategies

Covers oxygen weaning, CPAP, and mechanical ventilation decisions after resuscitation. Respiratory management must balance oxygenation with ventilator-induced injury risk.

Lesson 2 • Multi-Organ Monitoring Protocol

Establishes a structured approach to monitoring renal, hepatic, haematologic, and cardiac function. Early detection of organ dysfunction guides timely supportive care.

Lesson 3 • Glucose Homeostasis Management

Covers hypoglycaemia detection, treatment thresholds, and glucose infusion protocols. Glucose dysregulation worsens neurological outcomes after asphyxia.

Lesson 4 • Cardiovascular Monitoring and Support

Teaches assessment and management of haemodynamic compromise following asphyxia. Adequate perfusion is essential for limiting ongoing organ injury.

Lesson 1 • Rewarming Protocol and Post-Cooling Care

Covers controlled rewarming rate, monitoring during rewarming, and transition to normothermia. Rapid rewarming can trigger rebound injury and must be avoided.

Lesson 2 • Monitoring and Managing Adverse Effects

Identifies cooling-related complications including bradycardia, coagulopathy, and hypotension. Proactive monitoring prevents treatment-related harm.

Lesson 3 • Evidence Base and Eligibility Criteria

Reviews landmark trials and current eligibility criteria for therapeutic hypothermia. Ensures learners apply the treatment only to appropriate candidates.

Lesson 4 • Maintaining Target Temperature

Teaches continuous temperature monitoring and servo-control adjustments during 72-hour cooling. Consistent target temperature maximises neuroprotective benefit.

Lesson 1 • Amplitude-Integrated EEG Monitoring

Covers aEEG setup, pattern interpretation, and seizure detection at the bedside. Continuous brain monitoring guides anticonvulsant dosing and predicts prognosis.

Lesson 2 • First-Line Anticonvulsant Therapy

Provides dosing, administration, and monitoring protocols for phenobarbital as first-line treatment. Correct dosing prevents under-treatment and toxicity.

Lesson 3 • Recognising Neonatal Seizures

Distinguishes subtle, clonic, tonic, and myoclonic seizure types from non-epileptic movements. Accurate recognition is essential before initiating anticonvulsant therapy.

Lesson 4 • Neonatal Neurological Examination

Teaches a systematic neurological exam including tone, reflexes, and level of consciousness. Provides the clinical foundation for HIE staging and treatment decisions.

Lesson 1 • Prognostic Biomarkers and Imaging

Covers MRI, aEEG, and biomarkers used to predict neurodevelopmental outcomes after HIE. Accurate prognosis guides family counselling and resource allocation.

Lesson 2 • Communicating Prognosis to Families

Teaches evidence-based communication strategies for delivering uncertain or poor prognoses. Honest, compassionate communication builds trust and supports informed decision-making.

Lesson 3 • Bereavement and Palliative Care

Covers palliative care principles, comfort-focused management, and bereavement support for families. Addresses end-of-life decisions when prognosis is incompatible with meaningful survival.

Lesson 4 • Structured Neurodevelopmental Follow-Up

Establishes a follow-up schedule with standardised developmental assessments at key ages. Early identification of deficits enables timely therapeutic intervention.