• History: date/time of birth, prenatal history, birth history, estimated gestational age
• Exam: Respiratory rate and effort (grunting, retractions, gasping)
  • Heart rate
    • umbilical stump or brachial pulse, auscultation
  • Muscle tone
    • poor or strong
  • Color
    • central cyanosis, acrocyanosis, pallor
  • Apgar score
    • not necessary to guide resuscitation
  • Estimated gestational age
    • term or premature
  • Oxygen saturations
    • target of 85-95% at 10 minutes of age

Patient Safety Considerations

• Hypothermia is common in newborns, ensure heat retention by drying thoroughly, covering head, and wrapping in dry cloth
• When it does not encumber necessary intervention or assessment, skin-to-skin directly against mother’s chest and wrapping together is an effective warming technique
• Hypoglycemia can be a complication of hypothermia, consider BS check after resuscitation

Key Considerations

• Approximately 10% of newborn infants require some assistance to begin breathing
• Low birth weight infants are at risk for hypothermia
• Preferred placement of saturation probe is right upper extremity
• Titrate oxygen to saturations of 85-95% at 10 minutes of age
• Increase in heart rate is a reliable indicator of effective resuscitative efforts
• Acrocyanosis, a blue discoloration of the distal extremities, is a common finding in the newborn

Pediatric
not to exceed adult dose

• Assist with resuscitation per guidelines