Guideline

Guidelines on basic newborn resuscitation

Year of Publication

2012

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

19 included recommendations

In newly-born term or preterm babies who do not require positive-pressure ventilation, the cord should not be clamped earlier than one minute after birth

Status

Retired

Recommended against

Strong

When newly-born term or preterm babies requires positive-pressure ventilation, the cord should be clamped and cut to allow effective ventilation to be performed

Status

Retired

Recommended in favor

Conditional

Newly-born babies who do not breathe spontaneously after thorough drying should be stimulated by rubbing the back 2-3 times before clamping the cord and initiating positive-pressure ventilation

Status

Retired

Recommended in favor

Conditional

In neonates born through clear amniotic fluid who start breathing on their own after birth, suctioning of the mouth and nose should not be performed

Status

Maintained

Recommended against

Strong

In neonates born through clear amniotic fluid who do not start breathing after thorough drying and rubbing the back 2-3 times, suctioning of the mouth and nose should not be done routinely before initiating positive-pressure ventilation. Suctioning should be done only if the mouth or nose is full of secretions

Status

New

Recommended against

Conditional

In the presence of meconium-stained amniotic fluid, intrapartum suctioning of the mouth and nose at the delivery of the head is not recommended

Status

New

Recommended against

Strong

Certainty of evidence

Low

In neonates born through meconium-stained amniotic fluid who start breathing on their own, tracheal suctioning should not be performed

Status

New

Recommended against

Strong

Certainty of evidence

Moderate

In neonates born through meconium-stained amniotic fluid who start breathing on their own, suctioning of the mouth or nose is not recommended

Status

New

Recommended against

Conditional

In neonates born through meconium-stained amniotic fluid who do not start breathing on their own, tracheal suctioning should be done before initiating positive pressure ventilation

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

In neonates born through meconium-stained amniotic fluid who do not start breathing on their own, suctioning of the mouth and nose should be done before initiating positive-pressure ventilation.

Status

New

Recommended in favor

Conditional

In settings where mechanical equipment to generate negative pressure for suctioning is not available and a newly-born baby requires suctioning, a bulb syringe (single-use or easy to clean) is preferable to a mucous extractor with a trap in which the provider generates suction by aspiration

Status

New

Recommended in favor

Conditional

In newly-born babies who do not start breathing despite thorough drying and additional stimulation, positive-pressure ventilation should be initiated within one minute after birth.

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

In newly-born term or preterm (>32 weeks gestation) babies requiring positivepressure ventilation, ventilation should be initiated with air

Status

New

Recommended in favor

Strong

In newly-born babies requiring positive-pressure ventilation, ventilation should be provided using a self-inflating bag and mask.

Status

New

Recommended in favor

Conditional

In newly-born babies requiring positive-pressure ventilation, ventilation should be initiated using a face-mask interface

Status

New

Recommended in favor

Strong

Certainty of evidence

Low

In newly-born babies requiring positive-pressure ventilation, adequacy of ventilation should be assessed by measurement of the heart rate after 60 seconds of ventilation with visible chest movements

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

In newly-born babies who do not start breathing within one minute after birth, priority should be given to providing adequate ventilation rather than to chest compressions

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

In newly-born babies with no detectable heart rate after 10 minutes of effective ventilation, resuscitation should be stopped

Status

New

Recommended in favor

Strong

In newly-born babies who continue to have a heart rate below 60/minute and no spontaneous breathing after 20 minutes of resuscitation, resuscitation should be stopped

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low