Question

A healthy mother delivers a term fetus via uncom.plicated normal vaginal delivery. At birth, the neonate is flaccid, cyanotic, and not responsive. After delivery to the warming table, the most appropriate initial step in resuscitation is A. Immediate laryngoscopy and endotracheal intubation

B. Umbilical vein catheterization and administration of epinephrine
C. Intraosseous administration of isotonic crystalloid
D. Vigorous stimulation by drying the neonate with towels followed by assessment of its status
E. Oropharyngeal suction and mask ventilation with 100% oxygen followed by chest compressions when a second person is available

Answer 1

The most appropriate initial step in resuscitation for a newborn who is flaccid, cyanotic, and not responsive after a normal vaginal delivery is oropharyngeal suction and mask ventilation with 100% oxygen followed by chest compressions when a second person is available.

Step-by-step explanation:

The most appropriate initial step in resuscitation for a newborn who is flaccid, cyanotic, and not responsive after a normal vaginal delivery is option E: oropharyngeal suction and mask ventilation with 100% oxygen followed by chest compressions when a second person is available.

After birth, the newborn's first breath inflates the lungs and closes the three shunts that directed oxygenated blood away from the lungs and liver during fetal life. Oropharyngeal suction can help clear any mucus obstructing the airway, and mask ventilation with 100% oxygen can aid in initiating breaths. Chest compressions are performed when the newborn does not respond to initial steps.

Other options listed in the question, such as endotracheal intubation, epinephrine administration, and intraosseous administration, are not the most appropriate initial steps in resuscitation for this scenario.