Final answer:
When a newborn does not respond to initial resuscitation efforts with face mask ventilation, the insertion of an endotracheal tube (ETT) is the next critical step to secure the airway and provide effective ventilation, particularly in the context of RDS where pulmonary surfactant therapy and mechanical ventilation might be necessary.
Step-by-step explanation:
In the situation described, where a newborn is not improving despite receiving face mask ventilation, and there is poor chest movement with no rise in heart rate, it would be advisable to insert an endotracheal tube (ETT). This is because the initial steps of reevaluating the mask fit and airway, and providing face mask ventilation have not led to the desired improvement. Initiating advanced airway management by inserting an ETT can secure the airway and provide more effective ventilation. In the context of respiratory distress syndrome (RDS), medical advances have introduced strategies such as pulmonary surfactant therapy, which significantly reduces mortality. Nevertheless, in emergencies, securing the airway and ensuring adequate ventilation is crucial, and intubation can provide this along with the option for mechanical ventilation if required.