Neonatal Resuscitation Algorithm with 2015 Updates

Alert the Neonatal Resuscitation Team. Counsel Parents.
One Minute
Deliver the Neonate
Assess tone, is the neonate
breathing, crying and at term?
Yes
Place baby with mom. Supportive care.
Continue to newborn care and evaluation.
Repeat APGAR at 5 min.
No
Suction for secretions, warm neonate, clear
the airway and stimulate the neonate
Assess heart rate (should be
greater than 100 BPM/MIN), is the
neonate having apnea or gasping for air?
No
Is the Neonate blue?
Having difficulty breathing?
Yes
Yes
Begin positive pressure ventilation.
Place ECG and SpO2 monitor.
If needed start supplementing O2, suction to
clear the airway and start CPAP if needed.
Check Heart Rate?
If less than 100 BPM/Min
No
Debrief the team and follow
postresuscitation care.
Yes
Assess for breathing and chest movement,
laryngeal mask placement.
Follow ventilation protocol if warranted.
No
Check Heart Rate?
If less than 60 BPM/Min
Optimal SpO2 Levels
1 min: 60-65%
2 min: 65-70%
3 min: 70-75%
5 min: 80-85%
10 min: 85-90%
Intubate. Begin resuscitation, chest
compressions and positive pressure ventilation,
keep SpO2 at 100%. Continue monitoring ECG,
SpO2 and evaluate for umbilical vein catheter.
Check Heart Rate?
If less than 60 BPM/min
Yes
Administer IV epinephrine, if the heart rate
doesn’t increase access for other causes
i.e. hypovolemia or pneumothorax.
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