NEONATAL RESUSCITATION ALGORITHM 2015

Antenatal counseling, Team briefing and equipment

check

Birth

Stay with mother for routine care:

Term? Tone? Breathing or Yes Warm and maintain normal temperature, position
crying? airway, clear secretions if needed, dry, ongoing
evaluation.
A No

1 Warm and maintain normal temperature, position

minute airway, clear secretions if needed, dry, stimulate

No
Apnea, gasping, or Labored breathing
HR below 100 bpm? or persistent cyanosis

Yes Yes

PPV Position and clear airway

SpO2 monitor SpO2 monitor
B Supplemental O2 as needed
Consider ECG monitor
Consider CPAP

No Post-resuscitation care
HR below 100 bpm?
Team debriefing

Yes

Check chest movement

Ventilation corrective steps if needed
ETT or laryngeal mask if needed Pre-ductal SpO2 Target

1 min 60-65%
No
HR below 60 bpm? 2 min 65-70%
3 min 70-75%
Yes 4 min 75-80%
5 min 80-85%
Intubate if not already done
Chest compressions 10 85-95%
C Coordinate with PPV min
100% O2
ECG monitor

HR below 60 bpm?

Yes

IV epinephrine
D If HR peristently below 60 bpm:
consider hypovolemia,
consider pneumothorax