A neonate is delivered in the emergency department and is apneic with a heart rate of 80 beats per minute. After initial stimulation, the neonate remains apneic. What is the most appropriate action regarding the umbilical cord?
Milk the umbilical cord three times before clamping.
Clamp the cord immediately to move the neonate to a radiant warmer for resuscitation.
Place the infant skin-to-skin on the mother while continuing stimulation.
Delay clamping for at least 30-60 seconds to provide placental transfusion.
According to the Neonatal Resuscitation Program (NRP) guidelines, the priority for a non-vigorous newborn who is not breathing is to initiate positive-pressure ventilation promptly. To facilitate effective resuscitation, the infant must be moved to a radiant warmer. Therefore, the umbilical cord should be clamped and cut immediately. While delayed cord clamping for 30-60 seconds is beneficial for vigorous infants, it is contraindicated when immediate resuscitation is necessary. Cord milking is not the priority, and waiting for spontaneous respirations is inappropriate in an apneic neonate.
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Why is cutting the umbilical cord immediately prioritized in an apneic neonate?
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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