Table 4.

Special Circumstances in Resuscitation of the Newly Born Infant

ConditionHistory/Clinical SignsActions
Mechanical blockage of the airway
 Meconium or mucus blockageMeconium-stained amniotic fluidIntubation for suctioning/ventilation
Poor chest wall movement
 Choanal atresiaPink when crying, cyanotic when quietOral airway
Endotracheal intubation
 Pharyngeal airway malformationPersistent retractions, poor air entryProne positioning, posterior nasopharyngeal tube
Impaired lung function
 PneumothoraxAsymmetrical breath soundsNeedle thoracentesis
Persistent cyanosis/bradycardia
 Pleural effusions/ascitesDiminished air movementImmediate intubation
Persistent cyanosis/bradycardiaNeedle thoracentesis, paracentesis
Possible volume expansion
 Congenital diaphragmatic herniaAsymmetrical breath soundsEndotracheal intubation
Persistent cyanosis/bradycardiaPlacement of orogastric catheter
Scaphoid abdomen
 Pneumonia/sepsisDiminished air movementEndotracheal intubation
Persistent cyanosis/bradycardiaPossible volume expansion
Impaired cardiac function
 Congenital heart diseasePersistent cyanosis/bradycardiaDiagnostic evaluation
 Fetal/maternal hemorrhagePallor; poor response to resuscitationVolume expansion, possibly including red blood cells