3 Replies Latest reply on Mar 13, 2020 7:02 AM by Patricia Sorrentino

    compression question.

    Angela Brooks

      Many students have asked me, Should you start compressions right away if you don't have a heart rate? I've been telling them to do ppv for 30sec first, but am now reconsidering. What is the recommendation?

        • Re: compression question.
          Brittney Wilson

          Hi Angela,

           

          I believe the experts at AAP could lend you some advice on this.

           

          You can reach out to them at lifesupport@aap.org

           

          Thank you.

          • Re: compression question.
            Michelle Donahoo

            The algorithm should be the same process. If you identify that during/after initial steps the patient is apneic/gasping then PPV should be initiated while someone is assessing HR with stethoscope.   Then assessment of BS and validation of effective PPV.  Always start with PPV even if initial HR is less than 60. It should improve within 15 seconds of effective ventilations.  If it doesn't improve then intubation of the airway if feasible prior to CC starting or if not feasible then start CC/Bag and mask then at 1 minute during reassess of HR get patient intubated.  Hope this helps.  NRP is not CAB, it's old school ABC.

            1 of 1 people found this helpful
              • Re: compression question.
                Patricia Sorrentino

                The key word in Michelle's answer is EFFECTIVE.

                You must have at least 30 seconds of EFFECTIVE PPV before starting chest compressions.

                It is hard to sit on your thumbs while the heart rate is low, but newborn issues are most likely respiratory (vs cardiac), so effective PPV may get that heart rate to rise and you will not need to do compressions.