Neonatal Resuscitation in the Emergency Department -

Neonatal Resuscitation in the Emergency Department
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Publication Date: December 2020 (Volume 17, Number 12)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. CME expires 12/01/2023.


Andrea T. Vo, MD
Pediatric Emergency Staff Physician, The Hospital for Sick Children, Toronto, Canada
Christine S. Cho, MD, MPH, MEd, FAAP
Associate Professor of Clinical Pediatrics, Keck Medicine of USC; Fellowship and Education Director, Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, CA

Peer Reviewers

Lizveth Fierro, MD
Assistant Professor of Emergency Medicine & Pediatric Emergency Medicine, Department of Emergency Medicine, Loma Linda University, Loma Linda, CA
Deborah A. Levine, MD
Assistant Professor of Clinical Emergency Medicine, Assistant Professor of Clinical Pediatrics, Weill Cornell Medicine, New York Presbyterian Hospital, Komansky Children’s Hospital, New York, NY


Although most neonates will not require resuscitation, emergency clinicians must be prepared to manage neonates who require respiratory assistance. This issue reviews current expert recommendations and consensus updates of the best practices in resuscitation of neonates. An overview of neonatal physiology provides a framework for understanding how neonatal resuscitation differs from that of children and adults. A step-wise, systematic approach is provided for identifying and managing newborns who require resuscitation. The treatment, management, and over-arching goals for neonatal resuscitation and newborn care are also reviewed.

Excerpt From This Issue

A 30-year-old healthy pregnant woman at 40 weeks' gestation presents to your community ED in labor. An infant is visibly crowning, and there is no obstetrician on site. As a medical team prepares to assist this precipitous delivery, what equipment should be prepared for the care of the neonate? What criteria would determine whether the infant can receive routine care?

Paramedics bring in an 18-year-old woman. She is complaining of abdominal pain for 1 day and fluid leaking from her vagina. She states that she is pregnant. She thinks her due date is in 2 weeks but says her prenatal care has been poor. The team delivers a baby girl stained with meconium fluid. The infant is limp and not crying. What are the priorities in assisting this baby? What equipment should be prepared if the mother's estimate is wrong and the baby is premature?

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