Practical aspects of resuscitating asphyxiated newborn infants

Of all newborn infants, 5% require some degree of basic life support at birth. Newborn resuscitation therefore is one of the most frequent procedures carried out in medicine. It is therefore important that the routines in use are evidence based. Newborn resuscitation can be divided into ten steps: (1) initial stabilisation; (2) evaluation; (3) ventilation; (4) oxygen supplementation; (5) external heart massage; (6) medication; (7) response assessment; (8) withdrawal; (9) post resuscitation care; and (10) documentation. The procedures used in these steps are rarely based on scientific investigation and there is a need for more research in this field. Training programmes, identification of risk cases and preparation for resuscitation should be part of the routine in all delivery units. It is underlined that the need for oxygen, external heart massage or medication is rare. Most depressed newborn infants manage well with suctioning, gentle tactile stimulation or a few ventilations with a bag and mask.