Neonatal Resuscitation Program (NRP) Steps
The transition from intrauterine to extrauterine life is critical. The NRP algorithm is based on the assessment of three key factors: gestation, muscle tone, and breathing/crying.
1. Initial Steps (First 30 Seconds)
- Provide warmth: Place under a radiant warmer.
- Position the airway: Position the head in a “sniffing” position.
- Clear secretions: Suction the mouth and then the nose (M before N).
- Dry and stimulate: Dry the infant and provide tactile stimulation.
2. Evaluation and Intervention
| Finding | Action |
|---|---|
| Heart Rate < 100 bpm or gasping | Initiate Positive Pressure Ventilation (PPV). |
| Heart Rate < 60 bpm | Start chest compressions (3:1 ratio). |
3. Advanced Resuscitation
- Adrenaline: Indicated if HR remains < 60 bpm despite adequate PPV and chest compressions for 60 seconds.
- Volume Expansion: Indicated if the infant appears to be in hypovolemic shock (pale, weak pulses, poor response to resuscitation).
NEET PG Hint: The most important and effective step in neonatal resuscitation is ventilation of the lungs. Always remember the acronym MR. SOPA for corrective steps if PPV is ineffective: Mask adjustment, Reposition airway, Suction mouth/nose, Open mouth, Pressure increase, Airway alternative.