7.4.1  The first five seconds

Table 7.3 summarises what you should do in the first 5 seconds after the baby is born if the signs of asphyxia are present. After you have seen this overview, we will look at the specific actions in detail.

Table 7.3  Actions in response to signs of neonatal asphyxia.

What is the newborn doing?AssessmentAction
Crying and moving limbsProbably a healthy babyResuscitation not needed
Weak breathing, not moving limbs, moderate cyanosisProbably moderately asphyxiatedAssist breathing by on and off ventilation (as described in Section 7.4.8)
Not crying, breathing or gasping; not moving limbs/floppy; may be cyanosed or meconium stainedProbably severely asphyxiated

Estimate heart rate

Call an assistant (family member or other)

Suction the oral, nasal and pharyngeal area in less than 5 seconds using a bulb syringe

On and off ventilation

As aboveHeart rate above 60 beats/minute
As aboveHeart rate below 60 beats/minuteAs above, but with the addition of cardiac massage (see Figure 7.4)

7.4  Neonatal resuscitation procedures

7.4.2  Checking the newborn’s heart rate