The NLS guidelines are specifically intended for resuscitation at birth. They deal with warming and drying and assessment of the newborn followed, if necessary, by resuscitation, which is mainly concerned with the initial inflation of the lungs and establishing stable respiration. This is different to resuscitation at any other time of life. In addition, the questions of oxygen administration, airway blockage, meconium aspiration and umbilical venous catheterisation are considered which are also usually only applicable to babies in the first hours of life.
The major difference between newborn guidelines and paediatric is in the ratio of compressions to ventilations in CPR. The ILCOR evaluation of the evidence for these two groups arrived at different conclusions. Newborn babies and those on medical neonatal units, special care units and postnatal wards should usually receive 3 compressions to 1 ventilation as the reason for resuscitation is most likely to be respiratory and this ratio is most likely to deliver an appropriate ventilation rate. If a baby is thought to have a primary cardiac cause for arrest, consideration should be given to 15 compressions to 2 ventilations.
A baby who has successfully adapted to extrauterine life and has subsequently collapsed and presented to A&E or collapsed on a joint neonatal/paediatric medical and surgical intensive care unit should be resuscitated according to paediatric life support algorithms with a 15:2 compression to ventilation ratio.
May 2015, reviewed January 2023