A newborn receiving effective positive pressure ventilation for 30 seconds still has a heart rate of 50 bpm. Chest compressions are begun. What is the recommended compression to ventilation ratio in neonatal resuscitation?
- A 15:2
- B 3:1 ✓
- C 30:2
- D 5:1
Correct answer: B. 3:1
Explanation
Neonatal bradycardia is almost always due to hypoxia, so the emphasis is on ventilation. The NRP recommends a 3:1 compression to ventilation ratio, delivering about 90 compressions and 30 breaths per minute, because synchronized ventilation is the intervention most likely to reverse the bradycardia. The adult ratios of 30:2 and 15:2 apply to older patients where primary cardiac arrest is more common.
Reference: Nelson Textbook of Pediatrics, 21st ed.
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