Final answer:
In infants with a heart rate less than 100, gasping, or apneic, the goal is to start Positive Pressure Ventilation (PPV) within the first few minutes post-birth to help stabilize their breathing and circulation, as guided by the Apgar score, which is critical for assessing the newborn's immediate health after delivery.
Step-by-step explanation:
The goal of Positive Pressure Ventilation (PPV) for infants with a heart rate of less than 100, gasping, or being apneic is to quickly stabilize breathing and circulation, ideally within the first few minutes after birth. Neonatal resuscitation guidelines suggest initiating PPV promptly if the newborn is not breathing effectively or if the heart rate is below 100 beats per minute after initial steps of drying, providing warmth, positioning the airway, clearing secretions if needed, and stimulating breathing have been completed.
According to the Apgar score, which assesses the infant's color, heart rate, reflexes, muscle tone, and respiration right after birth, a score of 7 or higher indicates the baby is generally well, whereas a score below 7 suggests a need for some medical intervention, and a score below 5 is an emergency requiring immediate resuscitation efforts.
Heart rate and respiration are the most critical criteria within the Apgar score because they provide direct insight into the newborn's cardiopulmonary status. The newborn's first breath is a life-changing moment as it alters the circulatory pattern from fetal circulation to newborn circulation, closing shunts and increasing oxygen in the blood. PPV helps to support this transition if the infant is unable to establish effective breathing on its own.
A newborn typically shows an improvement in the Apgar score between the 1-minute and 5-minute assessments, advancing from intermediate scores to higher, indicating successful adaptation to the extra-uterine environment. However, if the child is apneic, gasping, or the heart rate remains below 100 beats per minute after initial steps, starting PPV within the golden minutes after birth is crucial.