ALS - Neonatal Resuscitation Protocol

From Paramedipedia - Ontario Paramedic Standards

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.

Indications

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

Contraindications

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

Procedure

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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Table of Contents Return to Paramedipedia-Ontario, Main Page Return to ALS - Patient Care Standards Return to ALS - Appendices Other Appendix 1 Titles: Symptom Relief Medical Directives Airway Emergencies ALS - Pediatric Croup Protocol Breathing Emergencies ALS - SOB/Respiratory Distress Protocol ALS - SOB/Respiratory Distress Protocol Diagram ALS - Moderate to Severe Asthma Exacerbation Protocol ALS - Anaphylaxis/Allergic Reaction Protocol ALS - Anaphylaxis/Allergic Reaction Protocol Diagram Circulation Emergencies ALS - Intravenous Access & Fluid Administration Protocol ALS - Suspected Cardiac Ischemia Chest Pain Protocol ALS - Suspected Cardiac Ischemia Chest Pain Protocol Diagram ALS - Acute Cardiogenic Pulmonary Edema Protocol Altered LOC Emergencies ALS - Altered LOC – Suspected Hypoglycemia Protocol ALS - Altered LOC – Suspected Hypoglycemia Protocol Diagram Cardiac Arrest Medical Directives Traumatic Arrest Emergencies ALS - General Traumatic Arrest Protocol – Adult & Pediatric ALS - PCP Blunt Traumatic Arrest Algorithm – Adult & Pediatric ALS - ACP Blunt Traumatic Arrest Algorithm – Adult & Pediatric ALS - PCP & ACP Penetrating Traumatic Arrest Algorithm – Adult & Pediatric Cardiac Arrest Emergencies ALS - Cardiac Arrest General Protocol (Non-traumatic) – Adult & Pediatric ALS - PCP Cardiac Arrest General Algorithm (Non-traumatic) – Adult & Pediatric ALS - ACP Cardiac Arrest General Algorithm (Non-traumatic) – Adult & Pediatric ALS - Cardiac Arrest Protocol – Defibrillation, Medication and Procedure Notes ALS - Neonatal Resuscitation Protocol ALS - Neonatal Resuscitation Algorithm Special Cardiac Arrest Emergencies ALS - Foreign Body Airway Obstruction Cardiac Arrest Protocol – Adult & Pediatric ALS - Hypothermic Cardiac Arrest General Protocol – Adult & Pediatric Post Arrest Emergencies ALS - Return of Spontaneous Circulation (ROSC) Protocol – Adult & Pediatric Reference Information ALS - CPR Guidelines Reference