1. Neonatal resuscitation

• Is the baby term?
• Is the baby breathing or crying?
• Is the tone good?

• Warm the baby, position the head in a slight sniffing position, and clear the airway only if secretions block it.
• Dry the baby, remove wet linen, and stimulate.
• Routine suction is not recommended, even for meconium-stained fluid.

• Start PPV if the baby is apneic, gasping, or has HR below 100.
• Use a rate of 40 to 60 breaths per minute.
• Start with room air (21%) in term babies and 21 to 30% in preterm babies. Titrate to pre-ductal SpO2.
• If HR is not rising, check the ventilation steps with MR SOPA: Mask adjustment, Reposition airway, Suction, Open mouth, Pressure increase, Alternative airway.

• Start if HR is below 60 after 30 seconds of effective PPV.
• Use 100% oxygen and consider intubation.
• Use the two-thumb encircling technique on the lower third of the sternum.
• Compress to one-third of the chest depth.
• Use a 3:1 ratio, which is 90 compressions and 30 breaths per minute.
• Reassess HR every 60 seconds.

• Epinephrine 1:10,000: 0.1 to 0.3 mL/kg (0.01 to 0.03 mg/kg) IV or through the umbilical vein, repeated every 3 to 5 minutes.
• Endotracheal epinephrine, while IV access is being obtained: 0.05 to 0.1 mg/kg.
• Volume expander (normal saline or Ringer's lactate): 10 mL/kg over 5 to 10 minutes, if hypovolemia is suspected.
• In India, "Helping Babies Breathe" and NRP-based training are the usual frameworks.

2. Pediatric basic and advanced life support

• Rate: 100 to 120 per minute.
• Depth: at least one-third of the AP chest diameter, about 4 cm in infants and 5 cm in children.
• Allow full recoil and minimize interruptions.
• Ratio: 30:2 for a single rescuer. For two rescuers, use 15:2 in a child with a pulse-check-trained team. For infants, use the two-thumb technique when two rescuers are present.
• If there is a pulse but breathing is inadequate, give 1 breath every 3 to 5 seconds.
• Use an AED. Pediatric pads are preferred for children under 8 years.

• Non-shockable (asystole or PEA): give epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV or IO every 3 to 5 minutes. Look for reversible causes.
• Shockable (VF or pulseless VT): shock at 2 J/kg, then 4 J/kg. Resume CPR for 2 minutes after each shock. Give epinephrine after the second shock. Give amiodarone 5 mg/kg (or lidocaine) for refractory VF or VT.
• Reversible causes (Hs and Ts): hypoxia, hypovolemia, hydrogen ion (acidosis), hypo/hyperkalemia, hypoglycemia, hypothermia, tension pneumothorax, tamponade, toxins, thrombosis.
• Fluids in shock: 10 to 20 mL/kg boluses of isotonic crystalloid, reassessing after each bolus.
• Bradycardia with poor perfusion: treat as arrest if HR stays below 60 despite oxygenation and ventilation.