For a full-term newborn with HR ≥100 and respiratory distress or central cyanosis, which intervention is recommended?

• A. Intubation
• B. Blow-by O2
• C. Chest compressions
• D. Suction mouth and nose only

Answer: (B)

When a full-term newborn has a heart rate at or above 100 and is experiencing respiratory distress or central cyanosis, the priority is to improve oxygenation with noninvasive support. Providing oxygen by blow-by delivers supplemental oxygen directly to the airway with minimal invasiveness, helping to correct hypoxemia that’s causing cyanosis and labored breathing while you monitor the infant’s response. Intubation or chest compressions aren’t needed here because the heart rate is adequate and there isn’t arrest or sustained apnea yet; those more invasive or life-support steps are reserved for when the infant’s condition worsens—such as a heart rate falling below 60 despite ventilation or ongoing apnea requiring advanced airway management. Suctioning the mouth and nose alone isn’t the main intervention for a distressed, cyanotic newborn who isn’t obstructed, so oxygen by blow-by is the most appropriate initial action. If oxygen alone doesn’t normalize status, you’d then escalate to noninvasive ventilation or further airway support as indicated.