Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
• Reassess the baby’s breathing after one minute.
o If the newborn cries and spontaneous breathing is established, stop ventilation and
observe for at least 5 minutes. If the baby is breathing normally (30-60 respiratory
movements/minute), proceed with routine essential newborn care.
o If the baby is still not breathing or is gasping, assess the heart rate with a stethoscope if
available, or by feeling the umbilical cord pulsations. Count the heart rate or the umbilical
pulsations for 6 seconds and multiply by 10 to obtain the heart rate per minute.
If the heart rate is more than 100/minute, continue ventilation.
If the heart rate is less than 100/minute, clear the infant’s airways again, reposition
the bag, and continue bagging until spontaneous breathing is established.
o If the heart rate cannot be evaluated, continue ventilation as long as the chest is
expanding well. If not, clear the infant’s airways again, reposition the bag, and continue
bagging until spontaneous breathing is established.
• If the baby is blue, especially in the mouth and tongue, give supplemental oxygen, if
available. (Figure 8.8.) Remember, most babies do not require supplemental oxygen for
resuscitation. If oxygen is administered, it can be carried out with the bag and mask.
Attach the oxygen tube to the resuscitator bag at the oxygen inlet end. Remember: if the
resuscitator bag is used, oxygen will reach the baby only if the bag is squeezed
repeatedly as in ventilation. Oxygen can be given to a baby that is already breathing but is
blue by holding the mask of the resuscitator bag above the face and squeezing the bag
periodically.
• Other methods of giving oxygen to a baby who is breathing are indicated in the diagrams
below. They include holding the oxygen tube with the flow of oxygen with or without a
cupped hand or through a facemask. In general a flow of 1-2 L/minute of oxygen should be
adequate.
Figure 8.8. Giving supplemental oxygen.
Integrated maternal and newborn care
Basic skills course
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