- Stimulate, position and warm. Dry with towels, stimulate with gentle rubbing or heal flicks. Suction oral and nasal passages with bulb syringe only if an obvious obstruction is seen or the neonate requires positive pressure ventilation.
Note – In premature infants with estimated gestational age < 30 weeks DO NOT towel dry. Instead, wrap in plastic or put infant in a plastic bag (not the head) and put on a hat if available.
- If any of the following are present, immediately start newborn resuscitation protocol.
Apneic or gasping
Heart rate < 100
If none of the above are present, continue below.
- Keep baby at the same level of the perineum for at least 1 minute. Clamp and cut the cord after waiting at least 30 seconds from delivery. Place one clamp six inches from the infant, the second clamp three inches distal from the first clamp. Cut the cord between the clamps. If cord continues to bleed, apply additional clamps.
- Record the time of birth. Determine APGAR scores at one and five minutes after birth. Normal respiratory rate is 40 60/minute and pulse is 120 160/minute. See below for normal preductal oxygen saturations in the neonatal period (in the right arm.) If the newborn is healthy and well-appearing, skin-to-skin contact with mother’s bare skin for several minutes is recommended before transport. Newborn should not be held in mother’s arms during ambulance transport – use newborn restraint and keep warm.
- Contact the receiving facility for early notification. Newborns are prone to hypothermia even in summer months. Use warmed blankets and newborn cap.
|Targeted Preductal SpO2 After Birth
||60% - 65%
||65% - 70%
||70% - 75%
||75% - 80%
||80% - 85%
||85% - 95%