In a newborn with HR <60, which sequence of actions is recommended?

• A. BVM with high-flow O2, chest compressions at 120/min, 3:1 C:V, check pulse every 1 min, stop when HR ≥60
• B. Ventilate with BVM on room air only
• C. Start chest compressions without ventilation
• D. Call for advanced airway and wait

Answer: (C)

When a newborn’s heart rate is below 60/min, the priority is to restore perfusion as quickly as possible. That means starting chest compressions immediately and providing ventilation as part of the CPR process. High-quality chest compressions at about 120/min with a 3:1 compression-to-ventilation ratio are used, delivering breaths through a bag–valve mask so that oxygenation accompanies the compressions. Do not delay compressions while waiting for advanced airway management; continue CPR and reassess frequently until the heart rate rises above 60/min or return of spontaneous circulation occurs. The emphasis is on not delaying CPR and integrating ventilation as you proceed.