During neonatal resuscitation, coordinated chest compressions and ventilations are required because the heart rate remains below 60 bpm despite effective positive pressure ventilation. What is the correct compression to ventilation ratio and the target number of events per minute?

• A 1:1, providing 60 compressions and 60 breaths per minute
• B 5:1, providing 120 compressions and 24 breaths per minute
• C 15:2, providing 90 compressions and 12 breaths per minute
• D 3:1, providing 90 compressions and 30 breaths per minute ✓

Explanation

The neonatal myocardium responds primarily to oxygenated blood rather than to compressions, so ventilation must not be compromised. The recommended ratio is 3 compressions followed by 1 breath, delivered over 2 seconds each cycle, giving approximately 120 events per minute: 90 compressions plus 30 ventilations. The adult ratios of 15:2 and 30:2 are inappropriate because they starve the neonate of ventilation, and 1:1 does not allow effective cardiac filling.

Reference: Textbook of Neonatal Resuscitation (AAP/AHA NRP), 8th ed.

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Written and medically reviewed by the StethoPrep medical team.