ABSTRACT
For apneic or bradycardic babies born at term, it is best to begin ressuscitation in the delivery room with air rather than 100% oxygen. Administration of supplementary oxygen should be regulated by blending oxygen and air, and the concentration delivered should be guided by oximetry. Preterm babies less than 32 weeks gestation may not reach the same arterial blood oxygen saturations in air as those achieved by term babies. Therefore, blended oxygen and air should be given guided by pulse oximetry. Detection of exhaled carbon dioxide in addition to clinical assessment is recommended as the most reliable method to confirm placement of a tracheal tube in neonates. If presented with a floppy, apnoeic baby born through meconium, it is reasonable to rapidly inspect the oropharynx to remove potential secretions. Tracheal intubation and suction may be useful. Therapeutic hypothermia should be considered for infants born at term or near-term with evolving moderate to severe hypoxic-ischemic encephalopathy, with protocol and follow-up coordinated through a regional perinatal system. For preterm babies of less than 28 weeks gestation delivery room temperatures should be at least 26 °C. They should be completely covered in a food-grade plastic bag up to their necks, without drying, immediately after birth. If the heart rate of a newly born baby is not detectable and remains undetectable for 10 min, it is then appropriate to consider stopping resuscitation. Simulation should be used as a methodology in resuscitation education.
