What is the first step in the newborn resuscitation algorithm?

The first step in the newborn resuscitation algorithm is to stimulate the newborn. This initial action is crucial as it helps to initiate breathing in a newborn who may be experiencing respiratory distress. Gentle stimulation, such as rubbing the back or flicking the soles of the feet, encourages the newborn to take its first breaths and begin the transition to breathing air outside the womb. This step is often effective for newborns who are not adjusting well at birth but do not require advanced interventions immediately.

Other actions, although important, come into play after stimulation. For example, administering oxygen is necessary if the newborn does not respond to stimulation and exhibits signs of inadequate oxygenation. Similarly, checking for a pulse and removing any airway obstruction are critical steps, but they typically follow the stimulation phase, as timely stimulation can sometimes resolve the need for further intervention. Thus, starting with stimulation aligns with the principle of addressing the most immediate need for the newborn in distress.