Call NICU 4-0057 and OB 4-3405  STAT

Assess gestational age, # of babies, meconium

Think WARM and DRY. 

Separate baby and mother.

If no meconium and vigorous:

1. Suction mouth, then nose.
2. Dry, stimulate, warm, and position for airway patency.  Consider oxygen.
3. Assess RR, HR (>100) and color (no central cyanosis).  If not normal, bag with 100% oxygen
4. Reassess in 30 seconds.  If not improving, intubate (3.5-4.0 full term, 2.5-3.0 preemie).  If HR < 60, begin CPR and place umbilical vein catheter.
5. Reassess RR, HR, and color in 30 seconds.  If not improving, give epinephrine (0.1-0.3 ml/kg of 1:10,000.
6. Check sugar and temperature early.

If thick meconium/non-vigorous + meconium:

• Suction with ETT attached to suction until clear or 2 times and consider re-intubation with positive pressure ventilation and 100% oxygen.
• Give oxygen, dry, stimulate, warm, and position for airway patency
• Assess and intervene as in above #3-6.

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