Chest compressions in newborn

When are chest compressions indicated in the resuscitation of the newly born infant? 

Effective ventilation usually restores vital signs to normal in a newborn, and chest compressions are generally not needed. Because chest compressions make effective ventilations more difficult and heart rate usually responds to assisted ventilation, chest compressions are not initiated until assisted ventilation has been started. The indications for the initiation of chest compressions during the resuscitation of the newly born infant are absent heart rate or heart rate less than 60 beats per minute despite adequate assisted ventilation with oxygen for 30 seconds. 

Sources

Kattwinkel J, Perlman JM, Aziz K, et al: Part 15: Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122(18 Suppl 3):S909-S919.

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