Neonatal Resuscitation

Abstract

Anticipating resuscitation. Most newborns make the fetal-to-neonatal transition without intervention. When any risk factor from a candidate list of potential moderate and high risk factors was present, 20 % of newborns required positive-pressure ventilation (PPV) to aerate their lungs. Given the large number of births each year, this represents a relatively frequent emergency. With appropriate attention to identifiable risk factors, most neonatal resuscitations can be anticipated before birth, however; even in the complete absence of risk factors a small proportion (0.2–7 %) will require PPV. Achieving the best outcome requires an organized and efficient response from a highly reliable team. Because the need for resuscitation cannot always be predicted, every birth should be attended by at least one qualified individual with neonatal resuscitation skills, including basic airway management and positive-pressure ventilation, whose only responsibility is providing care for the newly born infant. If risk factors are identified, additional personnel should be present at the time of birth. A team with advanced airway and vascular access skills should be identified and immediately available for resuscitation. Risk factors include: