EMT Exam: How to Resuscitate a Newborn

By Arthur Hsieh

The EMT exam will ask questions about resuscitating a newborn. The vast majority of newborns begin to cry almost immediately after birth. Sometimes there is something abnormal happening, and you need to stimulate the baby to begin breathing or intervene with breathing or circulation. Fortunately, for most newborns, it takes very little effort — you simply have to be aware and prepared to help the infant start breathing.

Here are some guidelines:

  • An early sign that you may need to resuscitate upon delivery is the presence of meconium. Meconium is a dark green/brown bowel movement that is released prematurely in the womb by the fetus in distress. It can cause serious lung illness if inhaled by the newborn. If you see meconium, have bulb syringes ready to suction the nose and mouth well before the newborn takes the first breath.

  • The act of drying the skin and suctioning the airway gets most newborns crying and moving. If the newborn is breathing inadequately after 15 to 30 seconds, place an oxygen mask near the face as you continue to suction with a bulb syringe. If breathing doesn’t improve or the newborn isn’t breathing at all, ventilate with a pediatric bag mask for another 15 to 30 seconds.

  • Check for a brachial pulse or for a pulse at the base of the umbilical cord where it enters the newborn’s abdomen. A healthy newborn’s rate is over 120 beats per minute. A rate between 60 and 100 should trigger the use of a bag-valve mask, because a rate that low is very likely to be respiratory driven.

    At a rate of less than 60, you need to compress the chest with a two-thumb encircling chest technique. Compress at a rate of at least 100 and ventilate once every three compressions.

    Check the rate every minute or so. It may take only that long to have the heart rate rise to a safe rate and the newborn breathe normally. Regardless, initiate transport as soon as possible.