Question

A full-term baby is born by emergency cesarean delivery because of fetal bradycardia. The baby is limp and not breathing after initial steps (dry, stimulate, position and clear airway). What is the next step in the resuscitation process?

1) Administer chest compressions
2) Administer epinephrine
3) Administer oxygen
4) Administer positive pressure ventilation

Answer 1

The next step after initial resuscitation efforts is to administer positive pressure ventilation to assist with breathing and oxygenation in a newborn who is limp and not breathing.

Step-by-step explanation:

If a full-term baby is born by emergency cesarean delivery due to fetal bradycardia and is limp and not breathing after the initial steps of drying, stimulating, positioning, and clearing the airway, the next step in the resuscitation process is to administer positive pressure ventilation (PPV). PPV is crucial to help inflate the baby's lungs and deliver oxygen to the bloodstream, as natural spontaneous breathing has not commenced.

Only if the heart rate remains extremely low or absent after administering PPV for an adequate duration should procedures such as chest compressions or administering epinephrine be considered, as per advanced neonatal resuscitation guidelines.