REMAC of N.Y.C. - B.L.S. Protocols

Regional Emergency Medical Advisory Committee of New York City
Prehospital Basic Life Support Protocols
Copyright January 1996 (8/96)

443 NEWBORN RESUSCITATION

For newborn infants with:

Persistent central cyanosis (longer than 15 to 30 seconds);
Respiratory rate less than 30 breaths per minute (hypoventilation);
Heart rate less than 100 beats per minute (bradycardia); OR
Cardiac arrest (absence of breathing and pulse):

Initiate Newborn Resuscitation procedures. (See guidelines below.)

Request Advanced Life Support assistance.

Transport, keeping the newborn warm.

GUIDELINES FOR NEWBORN RESUSCITATION

NOTE:

CARDIOPULMONARY RESUSCITATION IN A NEWBORN IS PERFORMED UTILIZING CHEST COMPRESSIONS WITH INTERPOSED VENTILATIONS IN A RATIO OF 3:1 AT A RATE OF 120 (90 COMPRESSIONS, 30 VENTILATIONS) PER MINUTE.

IF THE NEWBORN HAS:

PERSISTENT CENTRAL CYANOSIS;
A RESPIRATORY RATE LESS THAN 30 BREATHS PER MINUTE; OR
A HEART RATE BETWEEN 60 AND 100 BEATS PER MINUTE:
- Assist ventilation at a rate of 40 to 60 breaths per minute.
- Start CPR if the heart rate is between 60 and 80 beats per minute and not rapidly increasing after 30 seconds of assisted ventilation.
- Stop CPR and resume assisted ventilation at a rate of 40 to 60 breaths per minute once the heart rate is greater than 100 beats per minute.
- Switch to high concentration mask or "blow by" oxygen once the respiratory rate is greater than 30 breaths per minute, the heart rate is greater than 120 beats per minute, and central cyanosis disappears.

IF THE NEWBORN HAS:

A HEART RATE LESS THAN 60 BEATS PER MINUTE; OR
CARDIAC ARREST:
- Start CPR immediately.
- Stop CPR and begin assisted ventilation at a rate of 40 to 60 breaths per minute once the heart rate is greater than 100 beats per minute.
- Switch to high concentration mask or "blow by" oxygen once the heart rate is greater than 120 beats per minute, the respiratory rate is greater than 30 breaths per minute, and central cyanosis disappears.

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