Neonatal resuscitation is the set of interventions performed immediately after birth to support a newborn’s breathing and circulation. Most newborns require little to no help to begin breathing, but for the small percentage who do, this response is a planned and practiced series of actions. Videos depicting these events show a coordinated team effort aimed at helping the infant successfully transition from the womb to the outside world.
The Initial Moments After Birth
The first minute after a baby is born is called the “Golden Minute.” During this time, the delivery team performs a rapid evaluation to determine if the infant needs help. Videos of this phase show the team quickly answering key questions: Is the baby at term gestational age? Does the baby have good muscle tone? Is the baby breathing or crying vigorously? If the newborn is not crying or breathing well, the team immediately begins the resuscitation process.
A central component of this initial assessment is the Apgar score. This is a quick method to summarize the health of a newborn at one and five minutes after birth. The score evaluates five factors: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. While the Apgar score is recorded, the resuscitation team does not wait for the one-minute score to begin life-saving interventions if the initial assessment shows a problem.
Key Steps Shown in Resuscitation Videos
If a newborn requires assistance, a video will show the team moving the baby to a radiant warmer. This overhead heating unit helps the infant maintain a stable body temperature. The first actions involve drying the baby with warm blankets and providing gentle tactile stimulation, like rubbing the back, to encourage breathing. The team may also use a small suction catheter to clear the mouth and nose of any fluid blocking the airway.
If these initial steps do not result in effective breathing and a heart rate above 100 beats per minute, the next intervention shown is positive-pressure ventilation (PPV). A team member places a small mask, connected to a resuscitation bag, over the baby’s mouth and nose to create a seal. They then gently squeeze the bag to deliver breaths, with the goal of seeing the chest gently rise and fall.
During PPV, the team continuously monitors the baby’s heart rate. If the heart rate remains below 100 beats per minute despite effective ventilation, the team will re-evaluate their technique using corrective steps known by the acronym “MR. SOPA”: Mask adjustment, Repositioning the airway, Suctioning the mouth and nose, Opening the mouth, increasing the Pressure of the ventilations, and considering an Alternative airway. If the heart rate drops below 60 beats per minute, the situation becomes more serious.
At this point, chest compressions are initiated in coordination with PPV. One team member will perform compressions on the lower third of the sternum, while another continues to provide breaths. The ratio shown in videos is three compressions for every one breath, a rhythm designed to circulate oxygenated blood.
In some complex cases, advanced interventions are necessary. A video might show a provider performing an endotracheal intubation, where a small tube is inserted into the trachea to secure the airway for ventilation. Medications may also be administered, most commonly epinephrine, to help increase heart rate. These advanced steps are for infants who do not respond to the initial steps.
The Resuscitation Team and Equipment
A neonatal resuscitation is a team effort, and videos show a well-organized group of healthcare professionals. The team has a designated leader who directs the resuscitation, making decisions based on the infant’s response. Other members have specific roles, such as managing the airway, providing ventilation, performing chest compressions, and monitoring vital signs.
The scene in a resuscitation video is filled with specialized equipment, which is checked and prepared before a high-risk delivery. Viewers will see:
- A radiant warmer providing heat to the newborn.
- A suction catheter used to clear the airway.
- A bag-valve mask for delivering positive-pressure ventilation.
- A stethoscope to listen to the baby’s heart rate and breath sounds.
- A pulse oximeter for continuous readings of heart rate and blood oxygen.
- A cardiac monitor for a more accurate heart rate assessment.
The Purpose of Neonatal Resuscitation Videos
The primary purpose of most neonatal resuscitation videos is education and training. Many of the videos available are not recordings of actual emergencies but are high-fidelity simulations. These simulations use realistic infant manikins and real medical equipment to create a lifelike training environment. This allows healthcare teams to practice resuscitation skills in a controlled setting without risk to a patient.
These training videos help providers learn and retain the standardized steps of the Neonatal Resuscitation Program (NRP), the evidence-based guideline used in many countries. By watching and participating in simulations, team members can improve their communication, decision-making, and teamwork under pressure.
Video debriefing, where teams watch a recording of their own simulation performance, is a powerful learning tool. It allows them to see what went well and identify areas for improvement. These videos are created to help ensure that when a newborn does need help, the medical team is prepared to provide a rapid, coordinated, and effective response.