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What should be done first in neonatal resuscitation?

Answer :

In neonatal resuscitation firstly the newborn should be placed under a radiant heat source to offer warmth.

The baby should then be dried off, their airway should be cleared with a bulb syringe or suction catheter if necessary, and their breathing should be stimulated.

Clear the airway by suctioning the mouth first, followed by the nose, with a bulb syringe or suction catheter if the baby is energetic at birth (strong respiratory effort, such as crying, good muscular tone, heart rate > 100 bpm). If bradycardia develops when sucking, cease sucking and reassess the heart rate. Suctioning for intubation is not necessary.

The newborn needs tracheal suctioning if they are not active (decreased breathing, depressed muscle tone, and heart rate 100 bpm). Using a laryngoscope and a suction catheter under direct eyesight, first clean the mouth and posterior pharynx before inserting the endotracheal tube into the trachea. Connect an apparatus for suction to the endotracheal tube. As the tube is gently withdrawn, use suction. Repeat as necessary until the meconium is recovered or the heart rate drops down below 60 beats per minute, at which point immediate resuscitation is required. Give a soft yet forceful stimulation; touch the back and softly flick the soles.

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