Neonatal Resuscitation Algorithm For Zambia

Antenatal Counselling,
Equipment Check and
Team Briefing .

From Birth

Maintain normal temperature through out

BIRTH

Dry baby, stimulate & keep warm

(For preterm & babies less than 1.5kg
do not dry—wrap in a plastic bag)
Start clock.

Routine Care
Assess:
Baby Crying / Maintain Warmth
Colour, Tone, Breathing,
Breathing Well Keep airway clear
Heart Rate
Ongoing Evaluation
30 sec
Baby Gasping /
Not Breathing
Recheck head position
Chest not Consider 2 persons air-
way control + other air-
AT ALL TIMES ASK: DO YOU NEED HELP

Position in moving
way manoeuvers
NEUTRAL POSITION
Open the Airway, If Visible partic-
ulate matter suction
*Connect the monitor for Heart
Give 5 inflation breaths Lasting 2- Rate and SpO2 if available
3 seconds with room air*.
Acceptable
Preductal SPO2
2 min 60%
3 min 70%
30 sec Chest moving, Reassess: colour, tone, breathing, HR. If HR< 4 min 80%
60/min, start giving ventilation breaths with room air 15 5 min 85%
breaths in 30 seconds. Ensure chest rise. If SPO2 is less than 10 min 90%
acceptable preductal levels give supplemental O2

Monitor response to oxygen

Re-assess: Classify the condition
Improvement with colour, tone,
Colour, Tone, Breathing, Refer for management
Heart Rate breathing and heart rate
Update parents
Debrief team
If HR <than 60
beats / min

30 sec Start chest compression ratio 3:1

(3 compressions to 1 breath for 30
seconds) with with supplemental
O2. IV access, Check RBS, if hypo-
glycemic or unable to check give
10% dextrose at 3 -5 ml/kg.
Monitor response to oxygen
Monitor airway & breathing
Re-assess: Classify the condition
Improvement with colour, tone,
Colour, Tone, Breathing, Refer for management
breathing and heart rate
Heart Rate Update parents
Debrief team
If HR <than 60
30 sec beats / min

Continue compression + ventilation

breaths. Give 0.1ml/kg adrenaline
IV (1:10,000) as initial dose

Re-assess:
Colour, Tone, Breathing,
Heart Rate

If HR <than 60
30 sec beats / min

Continue compression + ventilation breaths. Give 0.3ml/kg

adrenaline IV (1:10,000) as second dose after 3-5 min
Correct hypovolemia if necessary (if evidence of APH in the mum)
10 -20 ml/kg/bwt IV slowly over 5-10 minutes

Re-assess:
Colour, Tone, Breathing,
Heart Rate

Previous steps were unsuccessful and

Update parents
the new born is has deteriorated. 1.Ministry of Health, Zambia-Neonatal Protocols.
Debrief team
Resuscitation can be called off after
16 min, 30 sec 20 minutes if there is no response 2. Resuscitation council, U.K, 2015 guidelines.