Presence of green amniotic fluid or green/black particulate material on face or in upper airway.
After completion of delivery, using a catheter or bulb syringe, suction mouth and then nose of newborn ONLY if there are signs of obvious obstruction or if the baby requires positive pressure ventilation (PPV).
Wipe away any collection of meconium in the upper airway with gauze-wrapped finger.
Request ALS if not already en route and initiate transport. Contact receiving facility for further orders if ALS is not on scene.