APPROVED
First Pro-Rector for Scientific and Pedagogical Affairs
Danylo Halytsky
Lviv National Medical University
___________________________
Prof. M.R. Gzhehotskyy
APPROVED
Dean of Medical Faculty No 1 ________________________ Prof. V.O. Sergienko
Dean of Medical Faculty No 2 ________________________ Prof. O. B. Nadraga
Dean of Faculty of Foreign Students _______________ Assoc. Prof. E.S. Varyvoda
APPROVED
At the meeting of the specialized methodical committee on pediatric disciplines of Danylo Halytsky
Lviv National Medical University
Protocol No._2_ of "30" March 2022
The Chairman of the specialized
methodical commission ________________________________ Prof. L.V. Besh
ALGORITHM
of the examination station
Objective Structured Clinical Examination (ОSCE-2)
6th year Medical Faculty
Subject «Pediatric diseases with pediatric infectious diseases»
STATION NAME: Neonatal Resuscitation
2
Performance Algorithm
STUDENT
EXAMINER
“Receives” a baby in blanket from a midwife
1. INITIAL STEPS
1  To provide the correct position on the resuscitation table,
suction mouth and nose, if necessary (asks examiner if the
baby has respiratory disorders or a significant amount
of oral content)1, dry with towel or blanket, remove wet linen,
stimulate by rubbing back or extremities
Vital Signs
2  To check breathing: asks examiner if the infant breaths
or has gasping respirations
2. POSITIVE-PRESSURE VENTILATION (PPV)
3  To call for help
4  To begin PPV not later than in 1 min after receiving the
baby
5  To ask assistant to attach pulsoximeter (PO) probe to the
right infant’s wrist and connect to monitor
6  Within 15 seconds of beginning PPV, without its interruption,
to request check to assess if heart rate is rising and evaluate
chest movements (asks examiner)2
Chest Movements
7.1  If chest movements observed, to continue PPV x 15 sec
7.2  If no chest movement observed (asks examiner), to proceed
through corrective steps until chest movement: 1) mask
adjustment, 2) reposition of the head, 3) to suction mouth and
nose, 4) to open mouth, 5) to increase pressure, 6) to indicate
the need for alternative airway – endotracheal tube (ETT) or
laryngeal mask.
 To administer effective PPV (with chest movements) x
8
30 seconds
Heart Rate (HR)
9  To check heart rate with stethoscope after 30 seconds of
effective PPV (asks examiner)
 To suggest using alternative airway and PPV via ETT
(laryngeal mask) for additional 30 seconds
3. CHEST COMPRESSIONS
10  To ask assistant to increase oxygen concentration to 100%
(to attach an oxygen tube and/or oxygen reservoir) and
ventilate the baby’s lungs
11  To perform chest compressions with coordinated
ventilation (rate – 90 per minute; thumbs positioned just
1
- information about infant’s condition will be provided by examiner.
«The baby does not
breath»
«The baby does not
breath»
PO probe is attached
«HR is about 30 and not
increasing»
Examiner confirms the
presence or absence of
chest movements in the
infant
«30 seconds passed»
«HR is about 40 bpm,
pulsoximeter is not
detecting a signal»
Examiner confirms
ventilation of baby’s lungs
«60 seconds passed»
3
STUDENT
EXAMINER
below the line between the nipples; compressions one-third
of the AP diameter of the chest; thumbs stay in touch with the
surface; 3 compressions to 1 ventilation every 2 sec)
Heart Rate (HR)
12  To check heart rate after 60 seconds of compressions «HR is about 30 bpm,
and ventilations with auscultation (to stop ventilation and pulsoximeter is not
remove mask from baby’s face) or pulsoximeter readings detecting a signal»
(asks examiner)
13  To indicate the need for administration of epinephrine Confirms performance
0.1-0.3 ml/kg (0.01% solution) intravenously (umbilical
venous catheter) and evaluate HR and SpO2 in 1 min after
that
14  To continue chest compressions and to determine HR «HR – 100 bpm. SpO2 –
(auscultation or pulsoximeter readings) after 60 seconds 68%»
(asks examiner)
4. DISCONTINUE COMPRESSIONS – CONTINUE PPV
15  To discontinue chest compressions and evaluate «No spontaneous
spontaneous breathing (asks examiner)
respirations»
16  To continue PPV with higher ventilation rate (40-60
breaths/min), assessing its effectiveness
17  To assess HR and spontaneous breathing after 30 seconds «HR > 100 bpm and he is
of effective PPV (asks examiner)
beginning to have some
gasping respirations.
SpO2 – 80%»
Vital Signs
18  To continue PPV and adjust oxygen concentration per «HR > 100 bpm,
oximetry. To assess HR, spontaneous respirations and SpO2 breathing spontaneously, SpO2 – 90%»
after 30 seconds of effective PPV (asks examiner)
19  To stop PPV if adequate spontaneous respiration will be
established
20  To inform parents about the results of resuscitations and
transport the infant to nursery
4
Neonatal Resuscitation Algorythm