If a newborn with persistent cyanosis after correct BVM technique and HR remains below 100, what should be added?

• A. High flow O2 15 L/min to BVM
• B. Turn down oxygen
• C. Immediately intubate
• D. Do nothing

Answer: (A)

When a newborn is cyanotic and the heart rate stays below 100 after effective bag-valve mask ventilation, the issue is inadequate oxygen delivery. The way to address this is to maximize oxygenation by delivering high concentrations of oxygen through the BVM. Using high-flow oxygen at about 15 L/min with the mask increases the fraction of inspired oxygen, helping to raise blood oxygen levels and support heart rate. Turning down oxygen would worsen hypoxemia, and intubation is not immediately required unless ventilation becomes ineffective or the situation deteriorates further. Doing nothing would allow continued hypoxia.