Neonatal Resuscitation Algorithm with 2020 Updates
| Alert the Neonatal Resuscitation Team. Counsel Parents. | |||||||||||||||
 |
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One Minute |
Deliver the Neonate | ||||||||||||||
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| 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. |
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No |
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| Suction for secretions, warm neonate, clear the airway and stimulate the neonate |
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| 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? |
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Yes |
|
Yes |
|
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| Begin positive pressure ventilation. Place ECG and SpO2 monitor. |
If needed start supplementing O2, suction to clear the airway and start CPAP if needed. |
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|
|
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| Check Heart Rate? If less than 100 BPM/Min |
No |
Debrief the team and follow postresuscitation care. |
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Yes |
|
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| Assess for breathing and chest movement, laryngeal mask placement. Follow ventilation protocol if warranted. |
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|
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No |
Check Heart Rate? If less than 60 BPM/Min |
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|
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| Intubate. Begin resuscitation, chest compressions and positive pressure ventilation, keep SpO2 at 100%. Continue monitoring ECG, SpO2 and evaluate for umbilical vein catheter. |
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|
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| Check Heart Rate? If less than 60 BPM/min |
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Yes |
 |
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| Administer IV epinephrine, if the heart rate doesn’t increase access for other causes i.e. hypovolemia or pneumothorax. |
|||||||||||||||
Neonatal Resuscitation Algorithm with 2020 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 |
|
|||||||||||||
|
|||||||||||||||
| 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. |
|||||||||||||||