References
Neonatal resuscitation

Around 5–10% of newborns require a degree of support to initiate and maintain a regular breathing rate immediately after birth, with approximately 1% of these needing extensive resuscitation measures, including medication management (Verklan et al, 2021). The updated Resuscitation Council UK guidelines (2021) contain detailed information about advanced neonatal life support that is specifically tailored to clinical practice in the UK.
While there are few major changes to the guidelines, there are updates in relation to neonatal vascular access for medications where the intraosseous route can be used if umbilical access is not possible. In addition, adrenalin/epinephrine initial and subsequent doses are now rationalised, and these can be repeated every 3–5 minutes in the absence of a response to the previous dose despite effective ventilation measures.
Neonatal resuscitation is a rapid response and high-pressure situation. Knowledge of the sequence of potential medications, the appropriate dosages and frequency, and routes of administration, is essential. The prescribing decision is informed by assessment of the neonate's heart rate, breathing, tone and time since birth with the medications detailed in Table 1 guiding management.
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