Special consideration in neonatal resuscitation

Delivery room resuscitation of neonates is performed according to evidence-based neonatal resuscitation guidelines. Neonatal resuscitation guidelines focus on the resuscitation of newborns suffering from perinatal asphyxia. Special considerations are needed when resuscitating newborns in locations other than the delivery room and for newborns with congenital anomalies. In this review, we examine the resuscitation of newborns at home and in the emergency department and highlight special considerations for resuscitating newborns with specific congenital anomalies. In addition, we explore the resuscitation of neonates in the neonatal intensive care unit and discuss the potential use of pediatric advanced life support guidelines. Finally, we highlight the importance of simulation to prepare teams for neonatal resuscitations. This review aims to prepare healthcare professionals in all disciplines caring for neonates at risk for requiring resuscitation under special circumstances. 1 Evidence-based neonatal resuscitation guidelines focus on resuscitation newborns suffering from perinatal asphyxia in the delivery room. 2 Modification of neonatal resuscitation guidelines is needed for newborn resuscitations outside the delivery room and to address certain congenital anomalies. 3 When resuscitating critically ill neonates in the intensive care unit suffering from arrest etiologies not covered in neonatal guidelines, teams may consider using pediatric advanced life support guidelines. 4 Simulation is a central part of neonatal resuscitation training and should be used to prepare for neonatal resuscitation in all circumstances. 5 With preparation and practice for special circumstances, healthcare teams can improve the quality of resuscitation for all neonates.