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Figure 6.10 Newborn life support algorithm.
two thumbs side by side over the lower third of the sternum, with the fingers encircling the torso and supporting the back (Figure 6.13).21,22,25,278,279 The lower third of the sternum is compressed to a
Figure 6.11 Newborn head in neutral position. © 2005 Resuscitation Council (UK).
depth of approximately one third of the anteriorposterior diameter of the chest. A compression to relaxation ratio with a slightly shorter compression than relaxation phase offers theoretical advantages for blood flow in the very young infant.280 Do not lift the thumbs off the sternum during the relaxation phase, but allow the chest wall to return to its relaxed position between compressions. Use a 3:1 ratio of compressions to ventilations, aiming to achieve approximately 120 events min−1 , i.e. approximately 90 compressions and 30 breaths. However, the quality of the compressions and breaths are more important than the rate.281 Check the heart rate after about 30 s and periodically thereafter. Discontinue chest compressions when the spontaneous heart rate is faster then 60 beats min−1 .