Table 40-20
- Initial Stabilization
- Place supine under a radiant heat source.
- Clear the airway with bulb suction.
- Assessment of Respirations and Heart Rate
- Ventilation
- Initiate positive-pressure ventilation if infant apneic, gasping, or heart rate is <100 beats/min.
- Guide delivered oxygen concentration based on preductal pulse oximetry.
- Chest Compressions
- Initiate if adequate ventilation with oxygen for 30 seconds and heart rate <60 beats/min.
- Strive for a 3:1 compression to ventilation ratio with 90 compressions and 30 breaths/min.
- Maintain ventilation and cardiac massage until the heart rate exceeds 60 beats/min.
- Medications and Volume Expansion
- Consider epinephrine and volume expansion if heart rate remains <60 beats/min despite adequate ventilation with 100% oxygen.
- Naloxone is not recommended.
- Hypovolemia frequently follows severe birth asphyxia (normal saline or lactated Ringer's solution).
- O-negative blood
- Albumin is not recommended.