Preparation (Antenatal)
- Communication with obstetric team
- Equipment check: warmer, O2, suction, BVM, towels
- Team briefing: roles assigned
At Birth (First 60 Seconds)
- Start clock at delivery
- Dry and stimulate
- Assess: breathing, heart rate, tone
NOTE
Most babies respond to drying and stimulation alone
If Not Breathing (Golden Minute)
Airway
- Neutral position (slight extension)
- Suction if meconium/secretions visible
Breathing
- 5 inflation breaths (sustained 2-3 sec each)
- Use 30cm H2O pressure (term), 25cm (preterm)
- Watch for chest rise
WARNING
If no chest rise after 5 breaths, reposition and try again
If HR <60 After 30 Seconds Ventilation
Circulation
- 3:1 ratio (3 compressions : 1 ventilation)
- Rate: 120 events/min (90 compressions + 30 breaths)
- Thumb technique for chest compressions
CAUTION
Encircle chest, thumbs on lower third of sternum
Drugs (Rarely Needed)
- Adrenaline 10-30 mcg/kg IV/IO (or 50-100 mcg/kg ETT)
- Consider if HR <60 despite CPR and ventilation
Checklist Complete