NALS Algorithm (Flowchart)
NALS Algorithm (Flowchart)
«Flowchart»

Birth

Birth

Birth

Infant is term gestation, amniotic fluid clear, breathing/crying, good muscle tone?

Infant is term gestation, amniotic fluid clear, breathing/crying, good muscle tone?

Infant is term gestation, amniotic fluid clear, breathing/crying, good muscle tone?

Warm, clear airway, dry, assess color and observe

Warm, clear airway, dry, assess color and observe

Warm, clear airway, dry, assess color and observe

Warm, position/clear airway, dry, stimulate, reposition

Warm, position/clear airway, dry, stimulate, reposition

Warm, position/clear airway, dry, stimulate, reposition

Evaluate respirations, HR, color

Evaluate respirations, HR, color

Evaluate respirations, HR, color


If breathing, HR>100 & Pink Observe
If breathing, HR>100 & Cyanosis Oxygen [If Pink with this, observe, if persistent cyanosis then BVM with 100% Oxygen and reassess every 30 seconds, if HR<60 then chest compressions]
If apnea or HR<100 BVM with 100% oxygen [If HR<60 then chest compressions also]


If breathing, HR>100 & Pink Observe
If breathing, HR>100 & Cyanosis Oxygen [If Pink with this, observe, if persistent cyanosis then BVM with 100% Oxygen and reassess every 30 seconds, if HR<60 then chest compressions]
If apnea or HR<100 BVM with 100% oxygen [If HR<60 then chest compressions also]


If breathing, HR>100 & Pink Observe
If breathing, HR>100 & Cyanosis Oxygen [If Pink with this, observe, if persistent cyanosis then BVM with 100% Oxygen and reassess every 30 seconds, if HR<60 then chest compressions]
If apnea or HR<100 BVM with 100% oxygen [If HR<60 then chest compressions also]


If breathing, HR>100 & Pink Observe RtArrow
If breathing, HR>100 & Cyanosis Oxygen [If Pink with this, observe, if persistent cyanosis then BVM with 100% Oxygen and reassess every 30 seconds, if HR<60 then chest compressions] RtArrow
If apnea or HR<100 BVM with 100% oxygen [If HR<60 then chest compressions also] RtArrow

Yes

Yes

Yes

No

No

No