NEONATAL FLOW ALGORITHM BIRTH Term gestation? Amnlotic fluid clear? Breathing or crying? Good muscle tone? Provide warmth Position clear airway* (as necessary) Dry, stimulate, reposition Routine Care Clear airway if needed Dry Assess color Evaluate respiration heart rate and color Give supplementary oxygen Observational Care Provide positive-pressure ventilation* Post-resuscitation care Provide positive-pressure ventilation* Administer chest compression Administer epinephrine and/ or volume* * Endotracheal intubation may be considered at several steps HR <60 HR >60 Persistent cyanosis Effective Ventilation, HR>100 & Pink Pink Breathing, HR>100 but cyanosis Breathing, HR>100 & Pink Yes No Apneic or HR <100 Approximate Time A B C D 30 sec