Neonatal Resuscitation Program Reference Chart
In accordance with the protocols of the American Heart Association and the American Academy of Pediatrics

The most important and effective action in neonatal resuscitation is ventilation of the baby's lungs with oxygen.

Resuscitation Flow Diagram
(Source: NRP Reference Chart)

NRP protocol flow diagram

Resuscitation ABCDs:

A - Airway

B - Breathing

C - Circulation

D - Drugs


Endotracheal Intubation
Gestational Age  
(weeks)
Weight
(kg)
ET tube size
(ID, mm)
Depth of insertion*
(cm from upper lip)
< 28
< 1.0
2.5
6 - 7
28 - 34
1.0 - 2.0
3.0
7 - 8
34 - 38
2.0 - 3.0
3.5
8 - 9
> 38
> 3.0
3.5 - 4.0
9 - 10
* Depth of insertion (cm) = 6 + weight (in kg)

Medications for Neonatal Resuscitation
Medication
Concentration
Preparation
Dosage/Route
Rate/Precautions
Epinephrine
1:10,000
1:10,000 solution in 1mL syringe
0.1-0.3mL/kg ET/IV
Give rapidly, flush with 0.5-1mL NS
Volume Expanders
NS, Ringer's, O- blood
Large syringe
10mL/kg IV (umbilical vein)
Give over 5-10mins
Sodium Bicarbonate
4.2% solution
Prefilled/prepared syringe
4mL/kg IV (umbilical vein)
Give slowly (0.5mL/kg/min) ONLY if effective ventilation
Naloxone
(for narcotic-induced respiratory depression)



0.1mg/kg IV/ET/IM/SQ
Give rapidly
Glucose
(for hypoglycemia)

D10W

2mL/kg IV
Give over 1-2mins, then continuous infusion
Phenobarbital
(for seizures)



20mg/kg IV
Give slowly (1mg/kg/min), may depress respiratory effort
Dopamine
(for hypotension)



2-20mcg/kg/min IV
Continuous infusion


Source:
Neonatal Resuscitation Program Reference Chart ©2000 American Academy of Pediatrics and American Heart Assocation


Entry date: July 27, 2003.