NRP Megacode Item Description

ItemLessonNMinimumMaximumMeanSD% of Participants for Each Score
1. Checks bag, mask, and oxygen supply correctly (when prompted to do so)1467021.970.
2. Asks questions to rapidly assess need for resuscitation1466021.910.300.29.090.8
3. Attends to temperature management2432021.950.230.24.495.4
4. If meconium is present, states indications for endotracheal suctioning (breathing, tone, HR)2456021.920.310.77.092.3
5. Positions, suctions mouth, then nose2468021.930.280.65.893.6
6. Dries, removes wet towels and repositions2465021.910.321.36.092.7
7. Requests description of breathing, HR, and color2428121.920.2708.291.8
8. Indicates need for assisted ventilation (infant is apneic or HR <100/min)3464121.970.1602.697.4
9. Provides assisted ventilation correctly (student should initiate ventilation at 40- 60/min at 30–40 then 15–20 cm of water; may prompt)3466021.950.230.43.695.9
10. Checks for chest rising3465021.970.200.42.697.0
11. Indicates how to correct chest not rising (if chest rising, ask student how chest not rising can be corrected)3459021.900.341.56.591.9
12. Student asks for evaluation (“what findings would allow you to stop PPV?”)3428021.900.320.59.190.4
13. Identifies need for starting and stopping chest compressions (HR <60/min)4457021.960.230.72.896.5
14. Correctly provides chest compressions (appropriate positioning of fingers/thumbs and depth of compression)4457021.980.160.21.898.0
15. Continues assisted ventilation coordinated with chest compressions (appropriate rate and coordination)4422121.980.1401.998.1
16. Student correctly identifies need for endotracheal intubation5384121.920.2708.191.9
17. Student can intubate or assist (ask student to demonstrate intubation or assist intubation)5352021.950.
18. Identifies need for epinephrine (“The heart rate is <60/min despite ventilation and chest compression.”)6388021.960.
19. Identifies need for volume expansion, route and rate of instillation/infusion (may prompt)6354021.900.330.88.290.9
20. Identifies that baby adequately resuscitated (evaluation shows that HR >100, breathing, and pink; student should stop PPV and wean free-flow oxygen or indicate need for ongoing assisted ventilation)7402021.980.
  • HR indicates heart rate; PPV, positive pressure ventilation.