ABSTRACT
Chest compressions may be necessary if there is continued bradycardia (heart rate less than 60 beats/minute) after breathing is adequately supported. On rare occasions, medications are necessary and should be available (refer to Table 31.2 for the full list.). The most commonly used are as follows:
1. Epinephrine 1:10,000: 0.1-0.3 mL/kg IV or via endotracheal tube (ETT) given rapidly
2. Volume expanders: normal saline, Ringer’s lactate, or whole blood. Dose is 10 mL/kg IV over 5-10 minutes
3. Sodium bicarbonate 0.5 mEq/mL: 2 mEq/kg IV given over at least 2 minutes
4. Naloxone hydrochloride 1.0 mg/mL: 0.1 mg/kg IV or intramuscularly (IM) given rapidly
Delivery Room Resuscitation The need to treat the newborn is based on frequent evaluation of respirations, heart rate, and oxygenation. The algorithm in Figure 31.1 can be used as a guideline for the resuscitation of a term or late preterm infant. The Apgar score (outlined in Table 31.3) is a useful tool for communicating an infant's status, but should not be used to guide resuscitation.
