NRP

Assemble equipment:

  • Warm

    • Warmer

    • Towel/blankets to dry and remove

    • Temp sensor for prolonged resuscitation

    • Hat

    • Plastic bags/wrap if <32w

    • Thermal mattress if <32w

  • Ventilation

    • O2 set to 10L/min

    • If available, Oxygen blender set to 21%

    • T-piece resuscitator (for free-flow, CPAP and PPV)

    • Term/pre-term size mask, and self-inflating bag

  • Suction

    • Suction bulb syringe

    • 10-12F suction catheter attached to wall 80-100mmHg suction

    • Meconium aspirator

  • Alternative Airway Equipment

    • LMA size 1 and 5mL syringe

    • Laryngoscope:

      • Miller 0 preterm

      • Miller 1 term

    • ETT: 2.5-4

      • Size

        • 3mm for 28-34w

        • 3.5mm 34-38w

        • 4mm >38w

      • Depth of insertion

        • Gestation-based guidelines or use of the nasal-tragus length method

    • Stylet

    • Muko

    • Syringes

  • Monitor

    • Stethoscope

    • Cardiac/ECG monitor

    • SpO2 - Pulse Oximeter

    • CO2 capnography

  • Medications

    • Umbilical line kit

      • 3x Chlorhexidine swabs

      • Sterile drapes

      • Sterile gloves

      • Pick-up forceps (without teeth)

      • Scalpel

      • Gauze

      • Sterile tie tape

      • Tape

      • 3-way stop cock

      • Syringes (1mL, 3mL)

      • NS Flush

      • 5Fr Umbilical catheter (Can use Size 5 feeding tube as alternative)

    • Epinephrine [0.1mg/mL] (at 0.1mg/kg ETT) or diluted to get 0.01mg/kg UV/IV/IO

      • 10mL NS Flush and 18G needle to dilute in 10

      • 10mL NS Flush (to flush 2mL after Epi UV/IV/IO)

    • 250mL NS

  • For vigorous term and preterm infants, delayed cord clamping for 30 to 60 s is recommended

  • When meconium is present and the newborn is hypotonic with ineffective respirations, ‘routine intubation for tracheal suction is not suggested’.

    • Initial resuscitation and administration of PPV should be undertaken, as required.

    • Meconium remains a risk factor for abnormal transition and a team with advanced resuscitation skills should be present

  • For the term infant, resuscitation should start with 21% oxygen.

    • For preterm infants <35 weeks’ gestational age, recommended initial gas is 21%–30% oxygen

  • After 15 s of PPV, assessment of HR should take place.

    • If HR is not increasing, chest rise should be evaluated. If the chest is moving, a further 15 s of PPV should be administered before reassessment of HR.

    • If the chest is not moving, corrective steps (MR.SOPA) should be initiated. HR should be reassessed after 30 s of ventilation that moves the chest