What is the neonatal resuscitation algorithm first step?

• A. Warm, open airway & Dry, stimulate the baby
• B. BVM, SpO2, Cardiac Monitor
• C. Start CPR and get vascular access
• D. Epinephrine 1:10,000 0.01 mg/kg IV/IO q3-5 min

Answer: (A)

The first thing to do in neonatal resuscitation is keep the newborn warm, dry them, and stimulate breathing. This initial step supports the newborn’s transition from intrauterine to extrauterine life by reducing heat loss and encouraging spontaneous respirations. It sets the stage for assessing whether the baby is breathing adequately and whether further airway support is needed.

If the baby isn’t breathing or the heart rate is not improving after stimulation, you then proceed to ventilation with a bag-mask device and monitor oxygenation, and only later move to more advanced steps like chest compressions or medications. Medications such as epinephrine are reserved for persistent bradycardia or failure to respond to ventilation and CPR.