The majority on pre-hospital births are without complications, occasionally the infant will require minimal stimulation/resuscitation, most importantly is appropriate suctioning, stimulation, and warming of the infant.

1. Deliver head
2. Suction mouth, nose and posterior pharynx with bulb syringe
3. Deliver body
4. Clamp and cut cord
5. Dry
6. Stimulate
7. Cover head and KEEP WARM
8. If respirations are SLOW/GASPING/APNEIC: Position airway, Ventilate w/BVM and 100% O2 @ 40-60/min for 15-30 seconds.
9. If Heart Rate < 80 Continue Ventilations and Initiate CPR at > 100 compression/minute.
10. Request ALS Intercept for all Pre-Hospital Births.

INTERMEDIATE LIFE SUPPORT

1. If infant not responding to Oxygenation, Ventilations, or Compressions
2. Establish IV access or IO access.
3. Administer Epinephrine 1:10,000 0.01mg/kg , then repeat q 5/min. Contact Medical Control

ADVANCED LIFE SUPPORT

1. If meconium is present, visulize and suction hypopharynx, Intubate, and repeat until free of meconium.
2. Administer resuscitation medications via the Endotracheal tube with the newborn once the airway is secured. (Epi 1:1,000 0.1 mg/kg)
3. Administer Naloxone or Dextrose 25% if indicated.