Delivering and assessing neonatal positive pressure ventilation
THE CONTEXT
Positive pressure ventilation (PPV)* is described as the single most effective step for neonates who fail to breathe at birth. Adequate ventilation is essential for successful resuscitation.
Technique
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Hold the face mask firmly to obtain a good seal. Compress the bag with the fingers rather than the hands.
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Once effective chest rise is established, deliver 40–60 breaths per minute using a 'squeeze, two, three' sequence.
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Aim for chest rise resembling easy spontaneous breaths. Avoid excessive tidal volumes and a high ventilation rate.
Assessing the response
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An immediate increase in heart rate is the usual response to PPV after birth.
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If heart rate does not increase rapidly after 15 seconds, check chest movement and auscultate for breath sounds.
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If the chest does not rise and breath sounds are absent, take ventilation corrective steps, identified in the passage as MR SOPA.
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After 30 seconds of PPV, evaluate heart rate to determine follow-up action.