Queensland Health

Neonatal resuscitation reference chart

Airway
Airway O
O22 %
% O
O22 L/min
L/min Air
Air L/min
L/min

mix
Newborn Life Support

oxygen/air mix
·· Effective
Effective ventilation
ventilation isis the
the key
key toto successful
successful neonatal
neonatal resuscitation
resuscitation 21
21 00 10
10
·· Routine
Routine suctioning
suctioning NOTNOT required
required 30
30 11 99

Suggested oxygen/air
·· Suction
Suction ONLY
ONLY when
when obvious
obvious obstruction
obstruction 40
40 22 88

L/min
10 L/min
Term gestation? Maintain normal Positive
Positive pressure
pressure ventilation
ventilation 50
50 44 66
YES
Breathing or crying? temperature, ·· IfIf heart
heart rate
rate less
less than
than 100
100 bpm
bpm andand inadequate
inadequate ventilation
ventilation 60
60 55 55
At all stages ask: do you need help?

Stay with

10
Good tone? Ongoing evaluation

Suggested
Mother commence
commence PPV: PPV: 70
70 66 44
NO oo 40–60
40–60 breaths
breaths per
per minute
minute 80
80 7.5
7.5 2.5
2.5
Maintain normal temperature, oo Pressures*
Pressures* 30/5
30/5 cm
cm HH22OO (term
(term baby)
baby) or
or 20–25/5
20–25/5 cm
cm HH22O
O 90
90 99 11
Ensure open airway, (preterm baby)
(preterm baby) 100
100 10
10 00
·· Initially
1 minute

Stimulate Initially use

use air
air (term
(term baby)
baby) or
or up
up to
to 30%
30% (preterm
(preterm baby)
baby)
NO ·· Titrate O
O22 %
% O
O22 L/min
L/min Air
Air L/min
L/min
Titrate O O22 concentration
concentration withwith reference
reference to
to SpO
SpO22 and
and pressures
pressures as
as

mix
oxygen/air mix
indicated
indicated 21
21 00 88
NO Laboured breathing
HR below 100? 30
30 11 77

Suggested oxygen/air
** Pressures
Pressures refers
refers to
to positive
positive inspiratory
inspiratory pressure
pressure (PIP)
(PIP) and
and positive
positive end
end
or persistent
Gasping or apnoea? expiratory pressure (PEEP)
expiratory pressure (PEEP) 40
40 22 66
cyanosis?

L/min
88 L/min
YES Cardiac
Cardiac compressions
compressions 50
50 33 55
YES ·· Use
Use 22 thumb
thumb technique
technique compress
compress ⅓⅓ diameter
diameter of
of chest
chest over
over lower
lower ⅓
⅓ 60
60 44 44

Suggested
Positive pressure ventilation of
of sternum
sternum 70
70 55 33
·· Give
Give 33 compressions
compressions toto each
each breath 80 66 22

http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au

SpO2 monitoring Ensure open airway breath 80
SpO2 monitoring ·· Insert
Insert vascular
vascular access
access 90
90 77 11
Consider CPAP ·· Administer
Administer 100%
100% oxygen
oxygen 100
100 88 00
NO
HR below 100?
Endotracheal
Endotracheal intubation
intubation
YES
Corrected
Corrected age
age Actual
Actual weight
weight ETT
ETT internal
internal diameter
diameter ETT
ETT mark
mark at
at upper
upper lip
lip ETT
ETT suction
suction catheter
catheter size
size
Ensure open airway
Post-resuscitation (weeks)
(weeks) (kg)
(kg) (mm)
(mm) (cm)
(cm) (F)
(F)
Reduce leaks
Consider: care
Increase pressure & oxygen 23–24
23–24 0.5–0.6
0.5–0.6 5.5
5.5
Intubation or laryngeal mask
25–26
25–26 0.7–0.8
0.7–0.8 2.5
2.5 6.0
6.0 5–6
5–6
Targeted pre-ductal 27–29 0.9–1.0 6.5
27–29 0.9–1.0 6.5
SpO2 after birth
HR below 60? 30–32
30–32 1.1–1.4
1.1–1.4 7.0
7.0
1 min 60-70% 3.0
3.0 5–6
5–6
33–34
33–34 1.5–1.8
1.5–1.8 7.5
7.5

State of Queensland (Queensland Health) 2016

YES 2 min 65-85%
3 min 70-90% 35–37
35–37 1.9–2.4
1.9–2.4 8.0
8.0 6–8
6–8
Three chest compressions to 4 min 75-90% 3.5
3.5
each breath 38–40
38–40 2.5–3.1
2.5–3.1 8.5
8.5
5 min 80-90%
100% oxygen 10 min 85-90% 41–43
41–43 3.2–4.2
3.2–4.2 3.5–4.0
3.5–4.0 9.0
9.0 6–8
6–8
Intubation or laryngeal mask
Venous access ETT
ETT size
size ~~ Corrected
Corrected age
age (weeks)÷10
(weeks)÷10 ETT
ETT length
length ~~ Weight
Weight (kg)
(kg) ++ 66 cm
cm

Document Number: F16.5-2-V2-R21

IV Adrenaline 1:10,000 solution
Gestation (weeks) Dose Volume
Volume expanders
expanders
HR below 60?
23-26 0.1 mL
YES 27-37 0.25 mL 0.9
0.9 %
% sodium
sodium chloride
chloride Administer
Administer over
over several
several
Draw
Draw into
into large
large syringe
syringe for
for
38-43 0.5 mL or
or 10
10 mL/kg
mL/kg minutes
minutes and
and repeat
repeat as
as
IV Adrenaline UVC administration
UVC administration
O
O RhD
RhD negative
negative blood
blood required
required
Consider volume expansion 10-30 mcg/kg (0.1-0.3 mL/kg)
Refer
Refer to
to critical
critical blood
blood loss
loss protocol
protocol for
for neonates*
neonates*

*National Blood Authority (Australia), Patient Blood Management Guidelines: Module 6–Neonatal and Paediatrics Available at https://www.blood.gov.au

Abbreviations: CPAP Continuous positive airway pressure; ETT Endotracheal tube; HR Heart rate; SpO2 Oxygen saturation; UVC Umbilical vein catheter