Initiate a positive pressure ventilation if necessary
11
Consider using oxygen supplementation if necessary
12
Perform chest compressions if heart rate is less than 60 bpm after 30 seconds of ventilation
13
Consider drug therapy if heart rate is still less than 60 bpm after 60 seconds of effective assisted ventilation and chest compressions
14
Evaluate post-resuscitation care
15
Approval: Post-Resuscitation Care
16
Communicate with parents and the wider care team
17
Document resuscitation measures
18
Evaluate potential need for further care or transfer to a higher level of care
19
Transfer baby to post-resuscitation care
20
Arrangement of follow-up care
Check the baby's general appearance
Observe the baby's overall appearance to determine their condition. Pay attention to their skin color, responsiveness, and muscle tone. This step helps to assess the baby's initial condition and guide further resuscitation efforts.
1
1. Pale or blue
2
2. Pink or rosy
3
3. Mottled or blotchy
4
4. Cyanotic
5
5. Other
1
1. Alert and responsive
2
2. Lethargic or decreased activity
3
3. Unresponsive
1
1. Good muscle tone
2
2. Decreased muscle tone
3
3. Floppy or limp
Evaluate the baby's breathing
Assess the baby's breathing to determine if they are breathing normally or facing respiratory distress. This evaluation helps to identify the need for intervention to ensure adequate oxygen supply.
1
1. Breathing spontaneously and regularly
2
2. Experiencing irregular or labored breathing
3
3. Not breathing or gasping for air
1
1. Clear and normal sounds
2
2. Abnormal or diminished sounds
3
3. Absence of breath sounds
1
1. Administer positive pressure ventilation (PPV)
2
2. Provide supplemental oxygen
3
3. Insert an oropharyngeal airway
4
4. Perform endotracheal intubation
5
5. Other
Assess the baby's heart rate
Evaluate the baby's heart rate as it is a critical indicator of their cardiorespiratory status. Identifying the heart rate helps determine the appropriate resuscitation steps.
1
1. Heart rate above 100 bpm
2
2. Heart rate between 60 and 100 bpm
3
3. Heart rate below 60 bpm
4
4. No detectable heart rate
Determine if the baby is full term
Assess the baby's gestational age to have better insight into potential complications or specific resuscitation techniques required for preterm infants.
1
1. Full term (37-42 weeks)
2
2. Late preterm (34-36 weeks)
3
3. Moderately preterm (32-33 weeks)
4
4. Very preterm (<32 weeks)
5
5. Unknown
Identification if the baby has good muscle tone
Determine the baby's muscle tone to assess their neuromuscular condition. This evaluation helps detect any potential birth complications or neurological issues.
1
1. Good muscle tone
2
2. Decreased muscle tone
3
3. Hypotonia or flaccid muscle tone
4
4. Hypertonia or rigid muscle tone
5
5. Other
Judging if the baby is crying
Observe if the baby is crying as it indicates effective breathing and vocal cord function. Crying is an important sign of a compromised newborn.
1
1. Crying loudly and vigorously
2
2. Weak or feeble crying
3
3. No crying
Perform initial steps in stabilization
Carry out the necessary procedures to stabilize the baby's condition and provide them with essential care immediately after birth.
1
1. Position the baby's head
2
2. Clear and suction the airway
3
3. Dry the baby
4
4. Provide warmth
5
5. Other
Drying the baby
Gently dry the baby using a clean, warm towel or cloth to remove any excess moisture and promote warmth. Drying helps prevent heat loss and stimulates the baby's breathing.
1
1. Clean towel
2
2. Warm blanket
3
3. Disposable wipes
4
4. Bathrobe
5
5. Other
Ensure a clear airway for the baby
Maintain a clear and unobstructed airway for the baby to ensure proper breathing. This step helps prevent respiratory distress and facilitates adequate oxygen intake.
1
1. Airway clear and unobstructed
2
2. Airway partially obstructed
3
3. Airway fully obstructed
4
4. Other
1
1. Head tilt-chin lift maneuver
2
2. Jaw thrust maneuver
3
3. Suctioning with a bulb syringe
4
4. Insertion of an oropharyngeal airway
5
5. Other
Initiate a positive pressure ventilation if necessary
Commence positive pressure ventilation (PPV) if the baby is not breathing effectively or has a heart rate below the desired threshold. PPV helps deliver oxygen and support the baby's respiratory efforts.
1
1. Inadequate respiratory effort
2
2. Heart rate below 60 bpm
3
3. Absent breath sounds
4
4. Cyanotic appearance
5
5. Other
Consider using oxygen supplementation if necessary
Evaluate the need for administering supplemental oxygen to the baby. Oxygen supplementation is beneficial in cases where the baby's oxygen levels are low or their respiratory status requires increased oxygenation.
1
1. Low oxygen saturation levels
2
2. Persistent cyanosis
3
3. Inadequate respiratory effort despite PPV
4
4. Other
Perform chest compressions if heart rate is less than 60 bpm after 30 seconds of ventilation
Administer chest compressions if the baby's heart rate remains below 60 bpm after 30 seconds of effective positive pressure ventilation. Chest compressions help circulate oxygenated blood to vital organs.
1
1. Heart rate below 60 bpm after 30 seconds of ventilation
2
2. Absent heart rate
3
3. Other
Consider drug therapy if heart rate is still less than 60 bpm after 60 seconds of effective assisted ventilation and chest compressions
Evaluate the necessity and appropriateness of drug therapy if the baby's heart rate remains below 60 bpm after 60 seconds of effective assisted ventilation and chest compressions. Drug therapy can provide additional cardiac support.
1
1. Epinephrine
2
2. Sodium bicarbonate
3
3. Volume expanders
4
4. Dopamine
5
5. Other
Evaluate post-resuscitation care
Assess the baby's condition and response to resuscitation efforts following successful stabilization. This evaluation helps determine the need for continued medical intervention or additional care.
1
1. Stable and improving condition
2
2. Unstable or deteriorating condition
3
3. Require further intervention
4
4. No further intervention needed
5
5. Other
1
1. Continued PPV
2
2. Oxygen supplementation
3
3. Blood tests
4
4. Imaging studies
5
5. Other
Approval: Post-Resuscitation Care
Will be submitted for approval:
Evaluate post-resuscitation care
Will be submitted
Communicate with parents and the wider care team
Maintain effective communication with the baby's parents and the broader care team throughout the resuscitation process. This ensures coordinated efforts, emotional support, and shared decision-making.
Document resuscitation measures
Accurately record and document all resuscitation measures undertaken during the neonatal resuscitation process. This documentation provides essential information for medical records and future reference.
1
1. Delivery room
2
2. Operating room
3
3. Neonatal intensive care unit (NICU)
4
4. Other
Evaluate potential need for further care or transfer to a higher level of care
Assess the baby's condition thoroughly to determine if additional care beyond immediate resuscitation is required. This evaluation involves considering the need for specialized care at a higher-level facility.
1
1. Requires transfer to NICU
2
2. Requires immediate surgical intervention
3
3. Stable for care in the current facility
4
4. Other
Transfer baby to post-resuscitation care
Arrange and facilitate the transfer of the baby to the appropriate post-resuscitation care unit or designated facility following successful stabilization.
1
1. Neonatal intensive care unit (NICU)
2
2. Special care nursery
3
3. Pediatric ward
4
4. Other
Arrangement of follow-up care
Arrange appropriate follow-up care and consultations for the baby to ensure ongoing monitoring, assessment, and management of any complications or concerns arising from neonatal resuscitation.
