Neonatal Resuscitation Algorithm

Initial Assessment

• Term Gestation?
• Good Tone?
• Breathing or Crying?

Immediate Interventions

• Apnea or Gasping:
  • Initiate immediate intervention.
• Heart Rate (HR) Below 100/min:
  • Address immediately.
• Labored Breathing or Persistent Cyanosis:
  • Requires attention and possible intervention.

Routine Care (If Infant is Stable)

• Infant stays with mother.
• Actions:
  • Warm and maintain normal temperature.
  • Position airway correctly.
  • Clear secretions if needed.
  • Dry the infant.
• Ongoing Evaluation.

Targeted Preductal SpO2 Post-Birth

• 1 min: 60%-65%
• 2 min: 65%-70%
• 3 min: 70%-75%
• 4 min: 75%-80%
• 5 min: 80%-85%
• 10 min: 85%-95%

Resuscitation Steps

• Warm and Maintain Normal Temperature.
• Position Airway.
• Clear Secretions if Needed.
• Dry and Stimulate.
• Positive Pressure Ventilation (PPV).
• SpO2 Monitor.
• Consider ECG Monitor.
• Check Chest Movement.
• Ventilation Corrective Steps if Needed.
• Endotracheal Tube (ETT) or Laryngeal Mask if Needed.
• Supplementary O2 as Needed.
• Consider Continuous Positive Airway Pressure (CPAP).

Advanced Interventions

• Postresuscitation Care.
• Team Debriefing.
• Intubate if Not Already Done.
• Chest Compressions:
  • Coordinate with PPV.
  • Use 100% Oxygen.
• ECG Monitor.
• Consider Emergency Umbilical Venous Catheter (UVC).
• Intravenous (IV) Epinephrine if HR Persistently Below 60/min.
• Consider Hypovolemia.
• Consider Pneumothorax.

Pre-Resuscitation Preparation

• Birth: Immediate evaluation and intervention if necessary.
• Antenatal Counseling.
• Team Briefing and Equipment Check.

Notes:

• This algorithm provides structured guidance for neonatal resuscitation.
• It emphasizes evaluation, early intervention, and continuous monitoring.
• Collaboration and effective communication among the team are crucial.
• Adapt interventions based on the infant's response and clinical condition.

Information based on 2020 American Heart Association Guidelines.