Newborn Resuscitation

Question 1

What is the first thing to do?

Answer 1

Prep: Antenatal counselling with team briefing and equipment check

Question 2

After the birth what do you do first?

Answer 2

Dry baby, maintain temperature and start clock

Question 3

What do you do if a baby is gasping or not breathing?

Answer 3

Open airway
o Give 5 inflation breaths
▪ Inflation breaths aim to sustain pressure to open the lungs

o Consider SpO2 +/- ECG monitoring

o This should all be done within 1 minute of birth

Question 4

How do you reassess after attempting to deal with a gasping baby?

Answer 4

If no increase in heart rate look for chest movement during inflation

Question 5

What do you do if the chest is not moving with breaths?

Answer 5

o Recheck head position
o Consider 2-person airway control and other airway manoeuvres
o Repeat inflation breaths
o SpO2 +/- ECG monitoring
o Look for a response

If no increase rate, look for chest movement and repeat as above

Question 6

What do you do if the chest is moving and HR is not detectable or <60s?

Answer 6

ventilate for 30 seconds

Question 7

How do you continue to assess HR after these steps?

Answer 7

Reassess heart rate. If still < 60, start chest compressions and coordinate with ventilation
breaths at a rate of 3:1
• Reassess HR every 30 seconds
o If HR not detectable or < 60, consider venous access and drugs

Question 8

What should you do about temperature?

Answer 8

Maintain temperature throughout

Question 9

What is acceptable pre-ductal SpO2?

Answer 9

o 2 min: 60%
o 3 min: 70%
o 4 min: 80%
o 5 min: 85%
o 10 min: 90%

Question 10

When should airway suction be performed?

Answer 10

Airway suction should not be performed in a neonate unless there is obviously thick
meconium causing obstruction as it can cause reflex bradycardia (via vasovagal stimulation)

Question 11

What is the apgar score?

Answer 11

Used to assess the health

of a newborn baby

Question 12

When is the apgar score calculated?

Answer 12

1 and 5 minutes of age

Question 13

How do you get an apgar score?

Answer 13

Each parameter shown in
table is given a value of 0,
1 or 2 and added to
compute the score

Question 14

What are the boundaries for apgar scores?

Answer 14

0-3: very low
4-6: moderate
7-10: no further
intervention needed

Question 15

What do you do if a baby is born in a poor condition?

Answer 15

o Neonatal resuscitation

o Take paired cord blood samples after clamping using 2 clamps