ALS - Neonatal Resuscitation Protocol

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A paramedic should manage a neonate immediately following delivery or an infant <30 days old and in need of resuscitation according to the following protocol.


All neonates immediately following delivery or <30 days old and in need of resuscitation.


Patients who meet conditions for “obvious death” as per Basic Life Support Patient Care Standards OR who meet conditions of the DNR Standard.


1. Assess neonate for the presence of meconium, breathing, crying, good muscle tone and colour.

2. Provide warmth, position, and clear the airway by suctioning the mouth prior to suctioning the nose.

3. Dry, stimulate and reposition.

4. Give O2 as necessary.

5. Evaluate respirations, heart rate and colour.

6. Provide positive - pressure ventilation (± ETT for ACP only) if neonate is apneic or HR <100.

7. If HR <60 provide positive pressure ventilation for 30 seconds and reassess. If HR is still <60 begin chest compressions (refer to CPR Guidelines Reference).

8. Initiate transport (PCP only).

9. If no response to ventilations and CPR, consider epinephrine administration as per the ALS - Neonatal Resuscitation Algorithm (ACP only).

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Other Appendix 1 Titles:

Symptom Relief Medical Directives
Airway Emergencies
Breathing Emergencies
Circulation Emergencies
Altered LOC Emergencies
Cardiac Arrest Medical Directives
Traumatic Arrest Emergencies
Cardiac Arrest Emergencies
Special Cardiac Arrest Emergencies
Post Arrest Emergencies
Reference Information
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