The Neonatal Resuscitation Algorithm
This section summarises the Resuscitation Council UK Newborn Life Support (NLS) algorithm and the high‑value facts for clinical practice and exam revision (Resus UK 2025). The algorithm prioritises airway → effective lung inflation/ventilation → circulation, with early recognition and correction of reversible causes.
Reproduce the official Resus UK flowchart in local teaching materials and follow local maternity/neonatal protocols.
Core principle
- Ventilation first: most neonatal cardiac compromise is secondary to inadequate lung inflation. Effective positive‑pressure ventilation (PPV) is the single most important intervention and should be optimised before starting chest compressions.
Initial rapid assessment (first 30-60 seconds)
- Assess tone, breathing/effort, and heart rate (HR).
- Provide immediate care for all newborns: keep warm and dry, position airway (neutral or slight sniffing position), clear only obvious obstruction, and cover the head to prevent heat loss.
- Apply delayed cord clamping per obstetric guidance where appropriate, but do not delay urgent resuscitation for delayed clamping if the infant is compromised.
- Call for additional help early if risk factors are present or the baby is not vigorous.
When to start respiratory support
- Start PPV if the baby is apnoeic or gasping, or if HR is persistently < 100/min.