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Free Resources for Neonatal Resuscitation Exam Preparation

Prepare for your upcoming NRP test and NRP skills session with free resources provided by ACLS. We offer a range of resources such as: NRP curriculum, practice test, AAP eBook, flashcards or visite the main page. ACLS can provide everything you need to improve your knowledge, pass your exams, and provide impeccable neonatal care.

Neonatal Resuscitation Algorithm

Step 1
Antenatal counseling
Team briefing and equipment check

Step 2

Step 3
Term Gestation?
Good Tone?
Breathing or crying?


Infant stays with mother for routine care: warm and maintain normal temperature, position airway, clear seceretions if needed, dry.Ongoing evaluation


Step 4
Warm and maintain normal temperature, position airways, clear secretions if needed, dry, stimulate

Step 5
Apnea or gasping?
HR below 100/min?


Labored breathing or persistent cyanosis?



Step 6
SpO2 monitor
Consider ECG monitor

Position and clear airway
SpO2 monitor
Supplementry O2 as needed
Consider CPAP

Step 7
HR below 100/min?


Postresuscitation care
Team debriefing


Step 8
Check chest movement
Ventilation corrective steps if needed
ETT laryngeal mask if needed

Step 9
HR below 60/min?

Step 10
Intubate if not already done
Chest compressions
Coordinate with PPV
100% O2
ECG monitor
Consider emergency UVC

Step 11
HR below 60/min


Arrow up

Step 12
IV epinephrine
If HR persistently below 60/min
Consider hypovolemia
Consider pneumothorax.

Targeted pre-ductal SpO2
After Birth
1 min: 60%-65%
2 min: 65%-70%
3 min: 70%-75%
4 min: 75%-80%
5 min: 80%-85%
10 min: 85%-95%


  • Step 2 to step 6 should be completed in one minute.
  • If answer of step 9 is "NO", please move back to step 7.
NRP Algorithm by © American Heart Association — Update 2015

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Last reviewed by on Dec 10, 2019