If the newborn's heart rate is 100 bpm or less, which intervention is indicated?

• A. Blow-by Oxygen at 5 L/min
• B. CPR
• C. BVM with Room Air
• D. Do Nothing

Answer: (A)

When a newborn’s heart rate is 100 bpm or slower, the priority is to improve oxygenation to support perfusion. Delivering oxygen by blow-by at 5 L/min provides a quick, noninvasive way to increase the amount of oxygen reaching the lungs and blood, which can help raise the heart rate and improve overall oxygen delivery without delaying assessment or more definitive ventilation. If the heart rate does not respond or breathing is inadequate, escalate to bag-valve-mask ventilation with oxygen, and if the heart rate falls to 60 bpm or below, begin chest compressions. Do nothing would miss the opportunity to support a bradycardic infant, and using a bag-valve-mask immediately instead of a brief blow-by would be unnecessarily invasive at this early stage if the infant is not yet apneic or severely distressed.