Neonatal resuscitation is a high-risk event that may be required when a precipitous delivery occurs during prehospital transport or in the emergency department. Although neonatal resuscitation is not frequently needed, emergency clinicians must be prepared to manage neonates who require respiratory assistance.
Our recent issue Neonatal Resuscitation in the Emergency Department reviews current expert recommendations and consensus updates of the best practices in resuscitation of neonates. It also provides a step-wise, systematic approach to identify and manage newborns who require resuscitation.
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Here are a few key points:
- Once the neonate is born, perform a rapid assessment (30 seconds or less) of the newborn for these 3 criteria: (1) whether the baby appears to be at full term; (2) has good tone; and (3) is breathing/crying. If all 3 of these criteria have been met, the baby can stay with the mother for routine care (eg, drying, warming, nasal suctioning as needed).
- By the first minute of life, the normal neonate’s oxygen saturation (SpO2) is 60% to 65%, and it will increase steadily, by 10% approximately every 2 minutes. For example, by 3 minutes of life, a normal SpO2 is 70% to 75%; by 5 minutes, 80% to 85%. Only after approximately 10 minutes of life will the full-term, healthy neonate exhibit an SpO2 of 85% to 100%.
- If initiating positive pressure ventilation, ideal positive end-expiratory pressure is 5 cm H2O and peak inspiratory pressure is 20 to 25 cm H2O.
Last Updated on January 26, 2023