The term "newborn" refers to the infant in the first minutes to 3 hours following birth.
The vast majority of babies born at term will initiate spontaneous respirations within 10 to 30 seconds of birth. A small percentage will respond during drying and stimulation. Approximately 10% require ventilation and only about 1% require more extensive chest compressions and medications.
Refer to SJA Newborn Life Support Flowchart
All newborn resuscitations must be transported with active resuscitation to the nearest receiving ED.
Effective airway control and adequate ventilation are the keys to favourable outcomes in newborn patients.
Hypoglycaemia is evident if BGL is < 2.0mmol.
Preventing heat loss: Set ambient temperature to minimum of 26°C where possible.
Follow all steps of the Childbirth clinical skill prior to continuing
Provide appropriate padding for neutral alignment to open the airway.
Suction the mouth and nose of the newborn using a Penguin Suction Device or LCSU4 set to the lowest setting to ensure cleared airway. NOTE: Suction is not routinely recommended with newborns and may cause bradycardia and airway damage. Only suction if there is a clear indication for its use, e.g. meconium or blood clots in airway.
Stimulate baby to induce crying, e.g. rubbing with towel on back.
The priority is to ensure lung inflation:
Deliver 3x initial inflation breaths by way of Bag Valve Mask as per clinical skill
Initial positive pressure ventilation of term newborn patients should be initially delivered via BVM using room air only
Premature newborn patients (<32 weeks) should be ventilated with blended air (1 litre per minute)
As expanding the lungs is imperative in newborns, ensure that you get chest rise with initial inflation breaths, if poor response attempt to troubleshoot:
Glucoseas per CPG (only if cause for low BGL is strongly suspected, if BGL <2.0mmol/L)
Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
Priority 1 to nearest obstetric unit if patient time critical
To booked obstetric unit if patient stable
Pre-notify receiving facility in both circumstances
Critical & Extended Care (CCP, PSO)
As per Advanced Care (AP) guidelines
Termination of Resuscitation requires an ASMA consult via CSP in SOC.
Cardiac Arrest Secondary to Hypothermia:
Hypothermia in Western Australia as a cause of cardiac arrest is extremely rare and mostly accidental e.g. locked in a cool room. If you suspect that the cardiac arrest was secondary to hypothermia, the emphasis is on high performance CPR and transport.