Highlights of the 2010 Guidelines for CPR and ECC - ECC Guidelines

n e o n a t a l r e s u s c i t a t i o n
Supplementary Oxygen
2010 (New): Pulse oximetry, with the probe attached to the
right upper extremity, should be used to assess any need for
supplementary oxygen. For babies born at term, it is best
to begin resuscitation with air rather than 100% oxygen.
Administration of supplementary oxygen should be regulated
by blending oxygen and air, and the amount to be delivered
should be guided by oximetry monitored from the right upper
extremity (ie, usually the wrist or palm).
2005 (Old): If cyanosis, bradycardia, or other signs of
distress are noted in a breathing newborn during stabilization,
administration of 100% oxygen is indicated while the need for
additional intervention is determined.
Why: Evidence is now strong that healthy babies born at
term start with an arterial oxyhemoglobin saturation of 90%. Hyperoxia can be toxic, particularly to the preterm baby.
Suctioning
2010 (New): Suctioning immediately after birth (including
suctioning with a bulb syringe) should be reserved for babies
who have an obvious obstruction to spontaneous breathing
or require positive-pressure ventilation. There is insufficient
evidence to recommend a change in the current practice of
performing endotracheal suctioning of nonvigorous babies with
meconium-stained amniotic fluid.
2005 (Old): The person assisting delivery of the infant should
suction the infant’s nose and mouth with a bulb syringe after
delivery of the shoulders but before delivery of the chest.
Healthy, vigorous newly born infants generally do not require
suctioning after delivery. When the amniotic fluid is meconium
stained, suction the mouth, pharynx, and nose as soon as
the head is delivered (intrapartum suctioning) regardless of
whether the meconium is thin or thick. If the fluid contains
meconium and the infant has absent or depressed respirations,
decreased muscle tone, or heart rate