Verse 1 – History on Arrival Due date and gestational age, I ask it clear and calm, Multiple gestation? Twins or more in mom? Meconium in the fluid, delivery difficulties seen, Congenital disease in history we glean. Maternal meds in use—what was taken today? Risk factors noted, no judgment in the way. Substance use or smoking, we document and know, Every detail matters when the newborn shows. Chorus Breathing or crying? Term gestation? Good muscle tone—our first evaluation. Warm, dry, stimulate with care, Skin-to-skin if stable there. Maintain warmth, keep the pace, Heart rate guides this critical race. Verse 2 – Signs We Watch Respiratory distress in the air, Peripheral cyanosis—mottled skin we share, Central cyanosis—that’s not normal now, Altered responsiveness, bradycardia—watch how. Most newborns need warmth and time, But some require action in a rapid climb. If agonal breathing or apnea is shown, Or heart rate below one hundred is known— Within thirty seconds, if no improvement seen, We move to ventilation—clear and clean. Pre-Chorus Warm, dry, stimulate, bulb suction only if needed, If not breathing at thirty seconds—procedure completed: Move quickly to BVM with oxygen as required, Ventilation rate forty to sixty, as desired. Chorus If heart rate falls or effort is low, Chest rise and rhythm help us know. Pulse ox on the right hand tight, Four-lead monitor in sight. Supplemental oxygen when indicated, Reassess—never hesitated. Verse 3 – Differential Mindset Airway failure—secretions or drive, Infection lurking, we stay alive. Maternal medication effect in play, Hypovolemia, hypoglycemia may. Hypothermia slowing the fight, Congenital heart disease in the light. If heart rate stays below one hundred still, We optimize ventilation skill. If below sixty after effort and time, Start compressions—rhythm aligned. Two-thumb encircling technique we use, Continuous compressions—no excuse. If needed, IV or IO access in place, Crystalloid bolus ten mL per kg in case. If unresponsive to epinephrine given, Repeat once if protocol driven. Check glucose if not improving well, Below forty mg/dL—treat and quell. D10 at two mL per kg delivered, Titrate to seventy—stability secured. Bridge – Special Situations Meconium infant, not vigorous or strong, Bulb suction mouth and nose—then move along. Endotracheal suction no longer routine, Ventilate first—keep airway clean. If compressions and BVM don’t restore, Consider pneumothorax, hypoglycemia more. If still not responding in the span, Escalate airway per pediatric plan. Breakdown – Monitoring the Start Quality of cry, tone, respirations, Heart rate first in resuscitations. Pulse ox trends from sixty-five, Rising through minutes as baby thrives. Cord clamping delayed if stable and well, One minute preferred—unless resuscitation bell. APGAR scored at one and five, But never delay care to keep score alive. Appearance, pulse, grimace, activity, breath— Seven to ten means stable health. Four to six needs support and air, Three or below—urgent care. Final Chorus Warmth and ventilation lead the way, Heart rate tells us how to play. Most newborns only need our light— Drying, stimulating, keeping warm and right. But if distress begins to show, We act fast, let protocol flow. From first breath to stable tone, We guide them safely home. Outro Notify destination, communicate clear, Document times so all is near. In those first moments, calm and true, It’s teamwork that gets them through. From skin-to-skin to monitored start, We carry science—and heart.
