PERFORMANCE
STANDARDS
VERIFICATION CRITERIA Y, N COMMENTS
1.
The provider correctly prepares for newborn resuscitation.
Verify by direct observation (or role play if no clients), whether the provider:
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If not already done, dries the newborn and removes the wet cloth
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Quickly wraps or covers the newborn, except for the face and upper chest
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Places the newborn on its back on a clean, warm surface
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Tells the woman (and her support person), what is going to be done
Listens to her and responds attentively to her questions and concerns
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Provides continual emotional support and reassurance, as feasible
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2.
The provider correctly performs newborn resuscitation using a bag and mask.
Determine whether provider:
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Positions the head in a slightly extended position to open the airway
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Clears the airway by suctioning the mouth first and then the nose : o Introduces 5cm catheter into the newborn’s mouth and suction while withdrawing catheter o Introduces 3cm catheter into each nostril and suction while withdrawing catheter o Does not suction deep in the throat because this may cause the newborn’s heart to slow or breathing to stop o Is especially thorough with suctioning if there is blood or meconium in the newborn’s mouth and/or nose o Stimulates by rubbing the heel of the hand up and down along the infant’s spine o If the newborn is still not breathing, starts ventilating
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Quickly rechecks the position of the newborn’s head to make sure that the neck is slightly extended.
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Places the mask on the newborn’s face so that it covers the chin, mouth and nose.
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EOC Standards—March 2009 Newborn Resuscitation- 84

PERFORMANCE
STANDARDS
VERIFICATION CRITERIA Y, N
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Forms a seal between the mask and the newborn’s face
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Squeezes the bag with two fingers only or with the whole hand, depending on the size of the bag
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Checks the seal by ventilating two times and observing the rise of the chest
 If the newborn’s chest is rising: o Ventilates at a rate of 40 breaths/minute o Observes the chest for an easy rise and fall
 If the newborn’s chest is not rising: o Repeats suction of mouth and nose to remove mucus, blood or meconium from the airway o Checks the position of the head again to make sure the neck is slightly extended o Repositions the mask on the newborn’s face to improve the seal between mask and face o Squeezes the bag harder to increase ventilation pressure.
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Ventilates for 1 min and then stops and quickly assesses if the newborn is breathing spontaneously
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If breathing is normal (30–60 breaths/min) and there is no in-drawing of the chest and no grunting: o Puts in skin-to-skin contact with mother and covers o Observes breathing at frequent intervals o Measures the newborn’s axillary temperature. Keeps in skinto-skin contact to re-warm if temperature is less than 36°C or to maintain temperature o Encourages mother to begin breastfeeding
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If newborn is breathing but severe chest in-drawing is present: o Ventilates with oxygen o Calls pediatrician and immediately transfers to nursery for special care
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If there is no gasping or breathing at all after 20 min of ventilation, stops ventilating
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COMMENTS
EOC Standards—March 2009 Newborn Resuscitation- 85

3.
4.
PERFORMANCE
STANDARDS
The provider properly performs post-procedure tasks.
The provider records all information on the chart.
VERIFICATION CRITERIA Y, N
Verify by directly observing or asking the provider whether the provider correctly performs post-procedure tasks:
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Disposes of disposable suction catheters and mucus extractors in a leak-proof container or plastic bag OR flushes with 0.5% chlorine and soaks for 10 min to decontaminate, flushes and washes immediately x 3 with soapy water, flushes and rinses x 3 with clean water. Boils or steams x 20 min
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Takes the valve and mask apart and inspects for cracks and tears
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Wipes exposed surfaces of ambu bag and mask with gauze pad soaked in 60 to 90% alcohol or 0.5% chlorine; rinses immediately.
Washes with soap and water. Rinses with clean water, air or towel dries
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Washes hands thoroughly with soap and water and dries with a clean, dry cloth or air dries
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Reassembles the bag
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Tests the bag to make sure that it is functioning: o Blocks the valve outlet by making an airtight seal with the palm of her hand and observes if the bag re-inflates when the seal is released o Repeats the test with the mask attached to the bag
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Observe whether the provider records the following information in the chart:
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Condition of the newborn at birth
Procedures necessary to initiate breathing
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Time from birth to initiation of spontaneous breathing
Clinical observations during and after resuscitation measures
Outcome of resuscitation measures
In case of failed resuscitation measures, possible reasons for failure
Names of providers involved
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COMMENTS
EOC Standards—March 2009 Newborn Resuscitation- 86

Total of standards
Total observed
Total achieved
04
EOC Standards—March 2009 Newborn Resuscitation- 87