Roughly one newborn in ten needs help to begin breathing and about one in a hundred needs extensive resuscitation. The clock in the corner is the point: positive-pressure ventilation must be under way within the first 60 seconds of life if the newborn is apnoeic or the heart rate is under 100. Run three births, order MR SOPA, calculate the epinephrine, then sort the four respiratory syndromes and read the oxygen corridor.
Work the delivery room
Build the picture one finding at a time. The bench reads the findings the way a clinician does — who the baby is, how the birth went, what the film shows, and whether there is a saturation gap between the right hand and the foot.
A healthy newborn does not saturate 95 per cent at birth and should not be pushed there. Fetal preductal saturation is around 60 per cent and climbs over ten minutes as the lungs fill and pulmonary vascular resistance falls.
Before the birthPreparation is an assessment skill
Time of life
0:00
Birth
Heart rate
—
Not yet assessed
Preductal SpO2
—
Probe not on
Prepare
Before every birth, ask the four antenatal questions and agree the cord management plan.
Sort the respiratory distressFour syndromes, four different babies
Set the findings
Respiratory distress in the newborn looks the same from the doorway — tachypnoea above 60, nasal flaring, intercostal and subcostal retractions, grunting, cyanosis. The history and the film separate them.
The oxygen corridorTarget saturation climbs minute by minute
Enter a minute and a saturation
The target is a corridor, not a ceiling. Hyperoxia in the preterm infant fuels retinopathy of prematurity and bronchopulmonary dysplasia; hypoxia sustains pulmonary vasoconstriction.