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Part 11: Neonatal Resuscitation
2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With TreatmentRecommendations
Jeffrey M. Perlman, Co-Chair*; Jonathan Wyllie, Co-Chair*; John Kattwinkel; Dianne L. Atkins; Leon Chameides; Jay P. Goldsmith; Ruth Guinsburg; Mary Fran Hazinski; Colin Morley; Sam Richmond; Wendy M. Simon; Nalini Singhal; Edgardo Szyld; Masanori Tamura; Sithembiso Velaphi; on behalf of the Neonatal Resuscitation Chapter Collaborators
Note From the Writing Group: Throughout thisarticle, the reader will notice combinations of superscripted letters and numbers (eg, “Peripartum SuctioningNRP-011A, NRP-012A”). These callouts are hyperlinked to evidence-based worksheets, which were used in the development of this article. An appendix of worksheets, applicable to this article, is located at the end of the text. The worksheets are available in PDF format and are open access.pproximately 10% of newborns require some assistance to begin breathing at birth, and 1% require extensive resuscitation (LOE 41,2). Although the vast majority of newborn infants do not require intervention to make the transition from intrauterine to extrauterine life, the large number of births worldwide means that many infants require some assistance to achieve cardiorespiratory stability.Newborn infants who are born at term and are breathing or crying and have good tone must be dried and kept warm. These actions can be provided with the baby lying on the mother’s chest and should not require separation of mother and baby. All others need to be assessed to determine their need for one or more of the following actions in sequence: A. Initial steps in stabilization (dry and provide warmth,position, assess the airway, stimulate to breathe) B. Ventilation C. Chest compressions D. Medications or volume expansion Progression to the next step is initially based on simultaneous assessment of 2 vital characteristics: heart rate and respirations. Progression occurs only after successful completion of the preceding step. Approximately 30 seconds is allotted to complete each of the first 2steps successfully, reevaluate, and decide whether to progress to the next (see Figure: Newborn Resuscitation Algorithm). Since publication of the 2005 International Consensus on CPR and ECC Science With Treatment Recommendations,3,4 several controversial neonatal resuscitation issues have been identified. The literature was researched and a consensus was reached on the assessment of oxygenation...