In neonatal resuscitation, what is the correct initial sequence when the newborn is not breathing?

In neonatal resuscitation, what is the correct initial sequence when the newborn is not breathing?

• A. Ventilate first, then warming
• B. Initial warming and drying, then bag-valve-mask ventilation
• C. Suction only
• D. Immediately start chest compressions

Answer: (B)

Warmth and drying come first because newborns lose heat quickly, and keeping the baby warm improves outcomes and supports breathing efforts. After the baby is warmed and dried, assess whether they are breathing. If they are not breathing, start positive-pressure ventilation with a bag-valve mask to help inflate the lungs and stimulate respiration. Suction is not the default initial step unless there is a reason to clear the airway from secretions or meconium. Chest compressions are not started immediately; they are indicated only if the heart rate remains below about 60 bpm after a period of effective ventilation (about 30 seconds) and persistent apnea or gasping. This sequence emphasizes addressing temperature and oxygen delivery before moving on to more advanced interventions.

Warmth and drying come first because newborns lose heat quickly, and keeping the baby warm improves outcomes and supports breathing efforts. After the baby is warmed and dried, assess whether they are breathing. If they are not breathing, start positive-pressure ventilation with a bag-valve mask to help inflate the lungs and stimulate respiration. Suction is not the default initial step unless there is a reason to clear the airway from secretions or meconium. Chest compressions are not started immediately; they are indicated only if the heart rate remains below about 60 bpm after a period of effective ventilation (about 30 seconds) and persistent apnea or gasping. This sequence emphasizes addressing temperature and oxygen delivery before moving on to more advanced interventions.