After delivering a baby, the newborn's respirations are 20 per minute and the heart rate is 60 and falling. What is the immediate action?

After delivering a baby, the newborn's respirations are 20 per minute and the heart rate is 60 and falling. What is the immediate action?

• A. Begin chest compressions
• B. Begin respirations with a bag-valve-mask
• C. Deliver rapid oxygen via nasal cannula
• D. Clamp the umbilical cord immediately

Answer: (B)

Establishing effective ventilation is the priority. A newborn with inadequate breathing (20 breaths per minute, well below the normal 40–60) and a heart rate that’s falling needs immediate support to oxygenate and ventilate the lungs. Providing positive-pressure ventilation with a bag-valve-mask delivers better lung inflation and oxygen delivery, which typically helps the heart rate rise and improves perfusion quickly. Start PPV at about 40–60 breaths per minute with a good seal and visible chest rise. If, after about 30 seconds of effective ventilation, the heart rate remains under 60, then you would move to chest compressions. A nasal cannula doesn’t provide the necessary ventilation support in this moment, and clamping the umbilical cord isn’t an immediate resuscitation action.

Establishing effective ventilation is the priority. A newborn with inadequate breathing (20 breaths per minute, well below the normal 40–60) and a heart rate that’s falling needs immediate support to oxygenate and ventilate the lungs. Providing positive-pressure ventilation with a bag-valve-mask delivers better lung inflation and oxygen delivery, which typically helps the heart rate rise and improves perfusion quickly. Start PPV at about 40–60 breaths per minute with a good seal and visible chest rise. If, after about 30 seconds of effective ventilation, the heart rate remains under 60, then you would move to chest compressions. A nasal cannula doesn’t provide the necessary ventilation support in this moment, and clamping the umbilical cord isn’t an immediate resuscitation action.