Do bulb syringes conform to neonatal resuscitation guidelines?
Related Experiment Video
Updated: May 26, 2026

Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Pradeep Alur1, Jonathan Liss, Frank Ferrentino
1Department of Pediatrics, York Hospital, 1001 S. George Street, York, PA 17405, USA. palur@wellspan.org
Objective:
To reduce airway injury secondary to high suction pressures, the American Academy of Pediatrics Neonatal Resuscitation Program (NPR) recommends that suction pressures be less than 100 mm Hg. This study was conducted to determine if suction bulbs conform to these recommendations.
Study Design:
In this prospective in vitro study, 25 personnel involved in neonatal resuscitation squeezed a new bulb three times for each of six commercially available bulbs using their delivery suite technique. A calibrated, pneumatic transducer measured the pressure of each squeeze.
Results:
Only one bulb met the NRP guidelines with none of the participants exceeding 100mm Hg (p<0.001).
Conclusions:
Only one bulb met the NRP guidelines of generating pressures less than 100 mm Hg. This bulb's large size (3 oz) may preclude its use in premature infants. Individuals involved in resuscitating newborns need to be aware of the pressures generated to avoid injuring the delicate oral airway.

