Contents Chapter Topic Page Neonatology Respiratory Cardiology

Can attempt tactile stimulation
once only and briefly. Slap foot,
flick heel, or rub back.
None or gasping
Bag-mask-valve PPV with 100 % O2 for 30
seconds. O2 at 5 L/min. Rate of 40-60/min
(10-15 in 15 sec).
• Infant's neck slightly extended to
ensure open airway.
• Ensure gentle chest rise with bagging.
• If no chest rise:
• Reapply mask
• Reposition head
• Check for secretions, suction if
present.
• Ventilate with mouth slightly open
• Increase pressure slightly
After 30 secs of PPV with 100 % O2
Evaluate Heart Rate
Below 60
• Continue
ventilation
• Chest
Compressions
Initiate medications if
HR below 60 after 30
secs of PPV with
100% oxygen and
chest compressions.
Reevaluate every 30 secs
1. Evaluate Respiration *
< 100/min
60-100
⇒ Discontinue chest compressions
⇒ Continue ventilation
Pink or peripheral
cyanosis
Spontaneous
2. Evaluate Heart Rate
(Count for 6 seconds,X10)
Observe and
monitor
> 100/min
3. Evaluate Colour
Blue
Provide free flow
O2 by using
oxygen tubing
and cupped hand
method with flow
rate of at least 5
L/min until pink.
Withdraw slowly.
Above 100
• Watch for spontaneous
respiration (and do
appropriate bagging if nil)
• Once spontaneous
respiration is established
discontinue ventilation.
Notes on Chest Compressions:
• Provide firm surface or support for the back.
• Locate compression area. It is at the lower third of the sternum
just below an imaginary line drawn between the nipples.
• Compress sternum at a rate of 3 compressions and 1
ventilation per 2 secs, giving 90 compressions and 30
ventilations in 1 minute.
• Compression depth is 1/3 of AP diameter.
• After 30 seconds, stop compressions and check HR for 6
seconds X10
• Complications can occur if technique of chest compressions is
poor e.g. broken ribs, lacerated liver and pneumothorax.