When a newborn doesn’t breathe at birth, you have less than 60 seconds to start effective ventilation. In those critical moments, following the neonatal resuscitation algorithm gives healthcare teams absolute clarity on what to do and when. The stakes are high. Every newborn deserves the best chance at survival, and that begins with knowing the exact sequence of resuscitation steps.
The neonatal resuscitation algorithm provides that structured approach. Based on current ANZCOR and ILCOR guidelines, it maps out each decision point from the first assessment through to advanced interventions. It tells you when to escalate, what to monitor, and how heart rate guides every choice you make.
This guide walks you through the algorithm step by step. You’ll learn how to prepare your team and environment, when to start positive pressure ventilation, how to recognise when chest compressions are needed, and which vital signs drive your decisions. Whether you’re refreshing your skills or learning the algorithm for the first time, you’ll finish with a clear understanding of how to apply it in clinical practice.
What the neonatal algorithm covers
The neonatal resuscitation algorithm gives you a complete roadmap for managing newborns from the moment of birth through advanced resuscitation. It starts with routine care for healthy babies and progresses through escalating interventions when respiratory or cardiac support becomes necessary. You’ll follow the same structured pathway whether you’re helping a term baby who needs brief stimulation or a preterm infant requiring full cardiopulmonary support.
The three assessment zones
The algorithm divides newborn care into three distinct zones based on clinical presentation. Each zone determines your immediate actions and triggers specific decision points throughout the resuscitation process.
Your first assessment places the newborn into one of these categories:
- Breathing well, heart rate >100/min: Routine care with parent, skin-to-skin contact, delayed cord clamping
- Not breathing adequately or heart rate <100/min: Initial steps followed by positive pressure ventilation
- Apnoeic, gasping, or heart rate <60/min after ventilation: Advanced support including chest compressions and drugs
The algorithm uses heart rate as the primary vital sign because it tells you immediately whether your interventions are working.
Core interventions in sequence
The algorithm guides you through five levels of intervention, each building on the previous step. You only escalate when the current intervention fails to improve heart rate or respiratory effort within the specified time frame.
Here’s what the algorithm covers at each level:
| Level | Intervention | Timing | Decision Point |
|---|---|---|---|
| 1 | Initial assessment and stimulation | Birth to 60 seconds | Heart rate and breathing effort |
| 2 | Positive pressure ventilation | After 60 seconds | Heart rate response to ventilation |
| 3 | Ventilation corrective steps | 30 seconds of PPV | Heart rate remains <100/min |
| 4 | Chest compressions | 30 seconds after corrections | Heart rate <60/min despite effective ventilation |
| 5 | Vascular access and adrenaline | During compressions | Heart rate remains <60/min after 60 seconds |
Each step includes clear time markers that tell you when to reassess and when to move forward. The algorithm also specifies the monitoring equipment you need at each stage, from pulse oximetry for oxygen saturation targeting to ECG for continuous heart rate during advanced resuscitation.
Step 1. Prepare the team and environment
Effective neonatal resuscitation starts before the baby arrives. You need your team assembled, roles assigned, equipment checked, and the resuscitation area ready. This preparation phase determines whether you can act decisively in the first 60 seconds after birth or waste critical time searching for equipment or clarifying who does what. The neonatal resuscitation algorithm assumes you’ve completed these preparation steps, so you can focus entirely on clinical decision-making once the newborn delivers.
Assign roles before the birth
Your team needs clear role assignments at least 10 minutes before delivery. Each person must know their specific responsibility, especially in high-risk deliveries where you anticipate needing advanced support. For routine deliveries, one skilled person can manage the initial steps, but for anticipated complications, you need at least three people with defined roles.
Use this role assignment structure for high-risk deliveries:
| Role | Responsibilities | Required Skills |
|---|---|---|
| Team Leader | Directs resuscitation, makes escalation decisions | ALS/NRP certified |
| Airway Manager | Performs ventilation, intubation if needed | Advanced airway skills |
| Circulation Support | Performs chest compressions, administers drugs | CPR trained |
| Documentation/Support | Records times, prepares medications, assists | Medication knowledge |
Brief your team on the anticipated risk factors and agree on communication protocols. Establish who will announce heart rate assessments and who makes the decision to escalate interventions.
When everyone knows their role before the birth, you eliminate confusion during the critical first minutes of resuscitation.
Check your equipment systematically
Run through your equipment checklist every shift and again before each high-risk delivery. Missing equipment during a resuscitation forces dangerous delays. Your check must include both basic stabilisation tools and advanced resuscitation equipment, even if you don’t expect to need everything.
Walk through this equipment verification process:
Airway and breathing equipment:
- Bag-valve-mask in sizes 240mL (preterm) and 500mL (term)
- Face masks sizes 00, 0, and 1
- Laryngoscope with size 0 and 1 blades, spare bulbs
- Endotracheal tubes 2.5mm, 3.0mm, 3.5mm
- Suction catheter sizes 5Fr to 10Fr
- Oxygen source with functioning flow meter
Circulation and monitoring:
- ECG leads and pulse oximeter probe
- Umbilical catheterisation kit with 3.5Fr and 5Fr catheters
- Adrenaline 1:10,000 drawn up in 1mL syringe
- Normal saline for volume expansion
- Syringes (1mL, 3mL, 10mL, 20mL)
Thermal management:
- Radiant warmer tested and preheated
- Warm towels and blankets
- Plastic wrap or bag for babies <32 weeks
- Temperature probe
Set up the resuscitation area
Position your radiant warmer so the team can access the baby from both sides. Turn it on at least 10 minutes before delivery to reach optimal temperature. Place your monitoring equipment within arm’s reach so you can attach ECG leads and pulse oximetry without interrupting ventilation. Set your oxygen blender to 21% for term babies or 30% for preterm babies as your starting point, ready to adjust based on heart rate response and saturation targets.
Step 2. Evaluate the newborn at birth
Your assessment begins the moment the baby delivers. You have 60 seconds to evaluate three vital signs, determine whether the newborn needs support, and start any required interventions. This rapid evaluation determines which pathway in the neonatal resuscitation algorithm you follow. Your assessment skills during this critical window directly influence outcomes, so you need a systematic approach that captures essential information without delay.
Assess three vital signs simultaneously
Check breathing effort, heart rate, and muscle tone together during your first look at the newborn. These three signs tell you immediately whether the baby is transitioning normally or needs your help. You perform this assessment while the baby remains with the mother when possible, allowing delayed cord clamping for healthy newborns.
Observe these specific indicators:
Breathing effort:
- Strong cry or regular breathing rhythm
- Gasping, irregular breathing, or absent respiratory effort
- Chest rise and respiratory rate
Heart rate:
- Listen with stethoscope over apex of heart
- Palpate umbilical cord pulse if stethoscope unavailable
- Count for 6 seconds and multiply by 10 for quick estimate
Muscle tone:
- Active movement and flexed posture
- Some flexion with reduced activity
- Floppy, limp, or absent tone
Don’t wait for a precise heart rate count if the baby appears lifeless or is gasping. Start resuscitation immediately when you see absent or gasping respirations combined with poor tone, even before you confirm the exact heart rate.
Your initial assessment determines whether you proceed with routine care or escalate to active resuscitation within the first 60 seconds.
Use the 60-second decision window
The algorithm gives you 60 seconds from birth to complete your assessment, provide initial warmth and stimulation, and decide whether positive pressure ventilation is needed. This period, often called the golden minute, represents your window to intervene before hypoxia causes harm. Time your assessment carefully so you don’t delay critical interventions.
Start your mental timer at delivery. By 30 seconds, you should have dried the baby, provided gentle stimulation, and completed your initial assessment. If the newborn hasn’t established effective breathing or the heart rate remains below 100 beats per minute, you prepare for positive pressure ventilation. At 60 seconds, you must begin ventilation if respiratory effort is inadequate or heart rate is too low, regardless of whether you’ve completed every assessment step.
Place the newborn in the correct pathway
Your assessment findings place the baby into one of three distinct pathways in the neonatal resuscitation algorithm. Each pathway triggers specific actions and determines your next steps.
Match your findings to these pathways:
| Assessment Findings | Algorithm Pathway | Your Immediate Actions |
|---|---|---|
| Breathing well, HR >100/min, good tone | Routine care | Keep with mother, skin-to-skin, delayed cord clamping, ongoing monitoring |
| Not breathing adequately OR HR <100/min | Initial steps required | Dry, stimulate, open airway, reposition. If no improvement, start PPV at 60 seconds |
| Apnoeic or gasping with poor tone | Immediate resuscitation | Begin PPV immediately without waiting full 60 seconds |
Record the exact time you start any intervention. This timestamp becomes critical if you need to escalate care, administer drugs, or document the resuscitation event. Your documentation also guides post-resuscitation care decisions and helps the team understand how long the newborn required support.
Step 3. Apply initial stabilisation measures
Once you’ve placed the newborn on your assessment pathway, you move immediately into initial stabilisation measures. These actions support the baby’s transition to air breathing and prepare you for escalation if needed. You perform these steps within the first 60 seconds for all babies who don’t establish effective breathing or whose heart rate sits below 100 beats per minute. The neonatal resuscitation algorithm requires you complete these measures before starting positive pressure ventilation, but you work quickly because delays cost oxygen delivery to vital organs.
Dry and stimulate the baby
Remove wet towels and dry the baby thoroughly with warm, dry towels. Focus on the head, back, and trunk with gentle but firm rubbing motions. This drying process provides tactile stimulation that often triggers spontaneous breathing in babies who arrive floppy or with weak respiratory effort. You simultaneously achieve two goals: preventing heat loss and stimulating the baby to breathe.
Provide additional stimulation if drying alone doesn’t initiate breathing. Flick the soles of the feet or rub the baby’s back for 5 to 10 seconds. These techniques give safe, effective stimulation without causing harm. Never use aggressive methods like slapping the back or applying cold water, as these outdated techniques offer no benefit and may cause injury.
Stop stimulation after 30 seconds if the baby doesn’t respond with improved breathing effort or rising heart rate. Continued stimulation beyond this point wastes time you need for effective ventilation. Move directly to your next assessment and prepare for positive pressure ventilation rather than persisting with stimulation that clearly isn’t working.
Position the airway correctly
Place the baby on their back with the head in a neutral position. The correct head position creates a straight line from the baby’s nose through the pharynx to the trachea, allowing air to flow freely into the lungs. You achieve this neutral position by placing a small towel or blanket roll under the baby’s shoulders, which lifts the shoulders slightly and brings the head into alignment.
Proper head positioning alone can resolve airway obstruction in some newborns, eliminating the need for further intervention.
Avoid hyperextension or flexion of the neck. Hyperextension (head tilted too far back) collapses the trachea and blocks airflow. Flexion (chin to chest) closes the airway completely. Check your positioning by drawing an imaginary line from the external auditory meatus (ear hole) through the shoulder. This line should run nearly perpendicular to the surface beneath the baby.
Clear the airway only when needed
Suction the airway only when you see obvious obstruction such as blood, meconium, or thick secretions blocking the mouth or nose. Routine suctioning in all babies causes harm by delaying ventilation, triggering bradycardia, and damaging delicate oral tissues. The algorithm specifically instructs you to skip routine suctioning in favour of faster progression to ventilation when needed.
When you must suction, use this technique:
- Connect a suction catheter (8Fr or 10Fr) to suction set at 100mmHg maximum
- Suction the mouth first, then the nostrils
- Limit each suction pass to 5 seconds
- Avoid deep pharyngeal suctioning that triggers vagal bradycardia
Maintain normal temperature
Keep the baby under your preheated radiant warmer throughout all initial steps. Target a temperature between 36.5°C and 37.5°C as measured with a skin or rectal probe. Hypothermia increases oxygen consumption, worsens acidosis, and reduces survival rates, while hyperthermia may cause harm to the developing brain.
Apply these temperature management strategies based on gestational age:
| Gestational Age | Temperature Management | Equipment Needed |
|---|---|---|
| ≥32 weeks | Radiant warmer, dry towels | Warmer, temperature probe |
| 28-31 weeks | Radiant warmer, plastic wrap without drying | Warmer, food-grade plastic wrap, probe |
| <28 weeks | Radiant warmer, plastic wrap, thermal mattress | Warmer, wrap, mattress, probe |
Place extremely preterm babies (less than 32 weeks gestation) directly into a plastic bag up to their neck without drying them first. This technique preserves body heat more effectively than towel drying in these vulnerable infants.
Step 4. Start positive pressure ventilation
You begin positive pressure ventilation when the newborn hasn’t established effective breathing by 60 seconds after birth or when the heart rate remains below 100 beats per minute despite initial stabilisation measures. This step represents the single most important intervention in neonatal resuscitation. The neonatal resuscitation algorithm places ventilation as the cornerstone of successful resuscitation because most newborns who need help at birth have a primary respiratory problem, not a cardiac one. Your ability to deliver effective ventilation directly determines whether the baby recovers quickly or requires escalation to advanced support.
Confirm your indication for ventilation
Check the baby’s breathing and heart rate one final time before you begin ventilation. You start positive pressure ventilation when the baby shows apnoea, gasping respirations, or laboured breathing that fails to improve after initial steps. You also begin ventilation if the heart rate sits below 100 beats per minute, even if the baby demonstrates some respiratory effort, because inadequate ventilation causes this bradycardia.
Effective ventilation causes the heart rate to rise within 15 to 30 seconds, confirming you’ve achieved adequate lung inflation.
Record the exact time you begin ventilation. This timestamp guides your escalation decisions and helps you track how long the baby requires support. Note also whether you started ventilation at 60 seconds or earlier due to absent respiratory effort.
Set your initial ventilation parameters
Select your equipment based on the baby’s size and gestational age. Use a 500mL bag for term babies and a 240mL bag for preterm infants. Choose a face mask that covers the baby’s mouth and nose without overlapping the eyes or extending past the chin. Size 1 fits most term babies, while size 0 or 00 suits preterm infants.
Configure these initial ventilation settings:
| Parameter | Initial Setting | Adjustment Guidance |
|---|---|---|
| Oxygen concentration | 21% (term), 30% (preterm <35 weeks) | Increase to 100% if HR remains <60/min after 30 seconds |
| Inspiratory pressure | 25-30 cmH₂O (term), 20-25 cmH₂O (preterm) | Increase if chest doesn’t rise adequately |
| Ventilation rate | 40-60 breaths per minute | Count “squeeze-two-three, squeeze-two-three” |
| Inspiratory time | 0.5 seconds per breath | Watch for chest rise, not timing |
Set your oxygen blender to the recommended starting concentration before placing the mask. Connect your bag-valve-mask to the oxygen source and confirm gas flows through the system. Position your manometer (pressure gauge) where you can see it during ventilation to monitor the pressure you deliver with each breath.
Position the mask and deliver breaths
Place the mask on the baby’s face using a two-point or two-hand technique. The two-point technique works best when you’re alone: position your thumb and index finger around the mask to create a seal while your remaining fingers lift the jaw. For a better seal with a second person available, use both hands to hold the mask while your colleague squeezes the bag.
Apply these steps for effective mask ventilation:
- Position the mask over the nose and mouth, avoiding the eyes
- Lift the jaw into the mask rather than pushing the mask onto the face
- Apply gentle pressure to create an airtight seal
- Squeeze the bag at 40 to 60 breaths per minute
- Watch for chest rise with each breath
- Listen for breath sounds bilaterally with a stethoscope
Ventilate for 30 seconds before reassessing heart rate. Count your breaths aloud (“one, two, three” equals about one second) to maintain the correct rate. Your assistant should watch the chest rise and announce when they see adequate movement.
Assess heart rate after 30 seconds of ventilation
Stop ventilating briefly after 30 seconds and check the heart rate immediately. Your colleague should already have placed ECG leads on the baby’s chest and attached the pulse oximetry probe to the right hand or wrist (pre-ductal site) during your first 30 seconds of ventilation. These monitors give you continuous heart rate readings so you don’t need to stop ventilation for assessment after this initial check.
Follow these decision pathways based on heart rate response:
Heart rate rising and >100/min: Continue ventilation until the baby breathes spontaneously. Gradually reduce your support as respiratory effort improves.
Heart rate >60/min but not rising or <100/min: Perform ventilation corrective steps using the MR SOPA mnemonic (Mask adjustment, Reposition airway, Suction, Open mouth, Pressure increase, Airway alternative). These corrections address common problems that prevent effective ventilation.
Heart rate <60/min despite ventilation: Ensure you’ve completed MR SOPA corrections first. If the heart rate remains below 60 beats per minute after adequate ventilation with corrective steps, prepare immediately for chest compressions while continuing ventilation.
Step 5. Escalate to compressions and drugs
You reach this advanced level of the neonatal resuscitation algorithm when the baby’s heart rate remains below 60 beats per minute despite 30 seconds of effective positive pressure ventilation with corrective steps completed. At this point, the baby needs more than ventilation alone. You must provide chest compressions to restore cardiac output whilst establishing vascular access for medication administration. This critical escalation requires coordinated teamwork, precise technique, and immediate action because prolonged bradycardia causes irreversible organ damage.
Start chest compressions when ventilation fails
Begin chest compressions immediately when the heart rate stays below 60 beats per minute after you’ve confirmed effective ventilation. You need effective ventilation before compressions work, so verify you’ve completed all MR SOPA corrective steps and see chest rise with each breath. The most common reason compressions fail is inadequate ventilation, not a primary cardiac problem.
Apply the two-thumb technique for chest compressions in newborns. Place both thumbs on the lower third of the sternum, just below an imaginary line between the nipples, with your fingers encircling the chest and supporting the back. Depress the sternum approximately one-third of the anterior-posterior diameter of the chest (about 4cm in term babies, 3cm in preterm). This depth generates adequate cardiac output whilst avoiding injury to internal organs.
Coordinate compressions with ventilation using a 3:1 ratio: three compressions followed by one ventilation, aiming for 120 events per minute (90 compressions and 30 ventilations). Count aloud “one-and-two-and-three-and-breathe-and” to maintain the correct rhythm. One team member performs compressions whilst another provides ventilation through an endotracheal tube (preferred) or well-sealed face mask. This synchronised approach delivers oxygen whilst supporting circulation.
Chest compressions combined with effective ventilation should increase the heart rate above 60 beats per minute within 60 seconds if the technique is correct.
Establish vascular access immediately
Insert an umbilical venous catheter (UVC) as your first-choice route for medication and fluid administration during neonatal resuscitation. The umbilical vein provides rapid, reliable access with minimal interruption to compressions and ventilation. Your assistant should prepare the catheterisation kit whilst you continue compressions, so everything is ready when you need to administer drugs.
Follow this technique for emergency UVC insertion:
- Cut the umbilical cord 1-2cm above the skin with a sterile blade
- Identify the umbilical vein (single large, thin-walled vessel)
- Insert a 3.5Fr (preterm) or 5Fr (term) catheter 2-3cm until blood flows freely
- Secure the catheter and flush with normal saline
- Attach a three-way tap for medication administration
Alternative routes include intraosseous access in the proximal tibia if you cannot establish umbilical venous access within 60 seconds. The endotracheal tube serves as a last resort for adrenaline administration whilst you secure intravascular access, though this route delivers less reliable drug absorption.
Administer adrenaline for persistent bradycardia
Give adrenaline (1:10,000 concentration) when the heart rate remains below 60 beats per minute after 60 seconds of coordinated chest compressions and ventilation. This medication increases heart rate and cardiac contractility, giving the myocardium the boost it needs to recover. You calculate the dose based on the baby’s weight, which you estimate from gestational age if you don’t know the exact weight.
Use this dosing protocol for adrenaline administration:
| Route | Dose | Volume (if 3kg baby) | Timing |
|---|---|---|---|
| Intravenous/Intraosseous | 0.01-0.03 mg/kg | 0.3-0.9mL | Immediately after vascular access |
| Endotracheal | 0.05-0.1 mg/kg | 1.5-3mL | While establishing vascular access |
Flush the catheter with 2-3mL normal saline immediately after administering intravenous adrenaline to ensure the medication reaches the central circulation. Reassess the heart rate 60 seconds after each dose. Repeat intravenous adrenaline every 3 to 5 minutes if the heart rate remains below 60 beats per minute, whilst ensuring you maintain effective ventilation and compressions. Consider volume expansion with 10mL/kg normal saline if you suspect blood loss or hypovolaemia as the cause of persistent bradycardia.
Use heart rate to guide every decision
The neonatal resuscitation algorithm uses heart rate as the primary vital sign that determines your next action at every decision point. Unlike breathing effort or tone, heart rate provides an objective, measurable indicator of how well your interventions work. You reassess heart rate after each intervention step, and the response tells you whether to continue current support, escalate to more advanced measures, or begin weaning assistance. This heart rate-driven approach removes guesswork from resuscitation decisions and creates a consistent framework that works across all clinical scenarios.
Monitor heart rate continuously during resuscitation
Attach ECG leads to the baby’s chest within the first 30 seconds of starting any resuscitation intervention. ECG provides the most accurate, continuous heart rate reading without interrupting your ventilation or compressions. Place the leads on the right upper chest, left upper chest, and left lower abdomen using the three-lead configuration. This setup gives you a reliable heart rate display that updates second by second, allowing you to see immediate responses to your interventions.
Add pulse oximetry to your monitoring setup by attaching the probe to the baby’s right hand or wrist (pre-ductal site) once you’ve established effective ventilation. Whilst pulse oximetry primarily measures oxygen saturation, it also provides a heart rate reading you can use to verify your ECG values. Cross-check both monitors when you see unexpected heart rate changes, as artefact or poor contact can give false readings on either device.
Continuous ECG monitoring allows you to detect heart rate changes within seconds, letting you respond faster than intermittent auscultation ever could.
Apply specific heart rate thresholds at each step
Three critical heart rate thresholds appear throughout the neonatal resuscitation algorithm, each triggering a specific escalation in care. You must memorise these numbers and their corresponding actions because hesitation at these decision points costs valuable time.
Follow these heart rate-based decision rules:
| Heart Rate Finding | Your Action | Timeline |
|---|---|---|
| <100 beats/min at 60 seconds | Begin positive pressure ventilation | Immediately |
| <60 beats/min after 30 seconds of effective ventilation | Start chest compressions with continued ventilation | Without delay |
| <60 beats/min after 60 seconds of compressions | Administer adrenaline whilst continuing compressions and ventilation | As soon as vascular access established |
Check the heart rate exactly when the algorithm specifies: after 30 seconds of ventilation, after 60 seconds of chest compressions, and 60 seconds after each adrenaline dose. These timed reassessments prevent you from stopping effective interventions too early or persisting with ineffective techniques too long.
Watch for rising heart rate as your success indicator
A rising heart rate tells you your current intervention is working, even if the rate hasn’t reached 100 beats per minute yet. When you see the heart rate climb from 40 to 70 beats per minute within 30 seconds of starting ventilation, you know you’ve achieved effective lung inflation and can continue the same approach. Conversely, a static or falling heart rate despite your interventions means you must troubleshoot immediately or escalate to the next level of support.
Build confidence with practice and simulation
You master the neonatal resuscitation algorithm through deliberate practice, not just reading the steps. Regular simulation training builds muscle memory for critical actions like effective ventilation technique, chest compression depth, and adrenaline dosing calculations. Studies show that healthcare professionals who participate in high-fidelity simulation at least quarterly maintain higher skill levels and respond faster during actual resuscitations than those who rely solely on theoretical knowledge.
Schedule structured simulation sessions
Set up monthly team simulations that recreate the exact equipment, environment, and time pressure you’ll face during real resuscitations. Use a neonatal manikin that provides feedback on ventilation effectiveness, compression depth, and hand positioning. Run scenarios that cover the full spectrum of the algorithm, from routine stabilisation through to advanced resuscitation requiring compressions and drugs. Record each session on video so you can review your team’s performance and identify areas that need improvement.
Rotate through these core scenarios in your practice schedule:
- Term baby requiring brief ventilation only
- Preterm baby needing sustained ventilation support
- Baby requiring chest compressions and vascular access
- Unexpected difficult airway with failed mask ventilation
- Baby requiring volume expansion for suspected blood loss
Regular simulation training transforms theoretical algorithm knowledge into confident, coordinated action when seconds matter most.
Debrief immediately after each simulation
Conduct a structured debriief within 10 minutes of finishing each simulation session whilst the details remain fresh. Focus on specific decision points where you hesitated, communication breakdowns that delayed interventions, and technical skills that need refinement. Your team learns more from discussing what went wrong than from celebrating perfect runs. Ask each team member to identify one specific skill they’ll practise before the next simulation.
Practice individual skills like mask ventilation technique, umbilical catheter insertion, and ECG lead placement during quieter shifts. You can rehearse these technical components without a full team, building the proficiency you need when the algorithm demands immediate action.
Bringing it all together
The neonatal resuscitation algorithm gives you a structured pathway from birth through advanced resuscitation, with heart rate guiding every decision you make. You’ve learnt how to prepare your team and environment, evaluate the newborn systematically, apply initial stabilisation measures, deliver effective positive pressure ventilation, and escalate to compressions and drugs when needed. Each step builds on the previous one, creating a logical progression that removes uncertainty from high-pressure situations.
Your confidence with the algorithm grows through regular practice and simulation training that recreates the time pressure and decision points you’ll face during actual resuscitations. Combining theoretical knowledge with hands-on experience transforms algorithm steps into automatic responses when a newborn needs your help.
Ready to develop your resuscitation skills further? Explore our Advanced Life Support courses at Parasol Medical Training, where you’ll gain practical experience with neonatal and paediatric resuscitation techniques through expert-led training and high-fidelity simulation. Our nationally accredited programmes provide the hands-on practice you need to respond confidently when critical moments demand decisive action.
