Programme Lessons

Neonatal Resuscitation Programme Lessons

The NRP programme consists of nine lessons as follows :

Lesson 1:  Overview and Principles of Resuscitation

In lesson 1 participants will learn the Changes in physiology that occur when a baby is born

  • Sequence of steps to follow during resuscitation
  • Risk factors that can help predict which babies will require resuscitation.              
  • Equipment and personnel needed to resuscitate a newborn

Lesson 2:  Initial steps in Resuscitation

In Lesson 2 participants will learn how to

  • Decide if a newborn needs to be resuscitated.
  • Open the airway, and provide the initial steps of resuscitation.
  • Resuscitate a newborn when meconium is present.
  • Provide free-flow oxygen when needed.

Lesson 3:  Use of a Resuscitation Device for Positive-Pressure Ventilation.

In lesson 3 participants will learn

  • When to give positive-pressure ventilation
  • The similarities and differences among flow-inflating bags, self-inflating bags, and T-piece resuscitators
  • The operation of each device to provide positive-pressure ventilation
  • The correct placement of the masks on the newborn’s face
  • How to test and troubleshoot devices used to provide positive-pressure ventilation
  • How to evaluate the success of positive-pressure ventilation

Lesson 4: Chest Compressions 

In Lesson 4 participants will learn

  • When to begin chest compressions during resuscitation
  • How to administer chest compressions
  • How to coordinate chest compressions with positive-pressure ventilation
  • When to stop chest compressions


 Lesson 5:  Endotracheal Intubation

In Lesson 5 participants will learn

  • The indications for endotracheal intubation during resuscitation
  • How to select and prepare the appropriate equipment for endotracheal intubation
  • How to use the laryngoscope to insert an endotracheal tube
  • How to determine if the endotracheal tube is in the trachea
  • How to use the endotracheal tube to suction meconium from the trachea
  • How to use the endotracheal tube to administer positive-pressure ventilation


Lesson 6:  Medications

In Lesson 6 participants will learn

  • What medications to give during resuscitation
  • When to give medications during resuscitation
  • Where to give medications during resuscitation
  • How to insert an umbilical venous catheter
  • How to administer epinephrine
  • When and how to administer fluids intravenously to expand blood volume during a resuscitation.


Lesson 7:  Special Considerations

In Lesson 7 participants will learn about

  • Special situations that may complicate resuscitation and cause ongoing problems
  • Subsequent management of the baby who has required resuscitation
  • How the principles in this program can be applied to babies who require resuscitation  beyond the immediate newborn period or outside the hospital delivery room.


Lesson 8: Resuscitation of Babies Born Preterm

In Lesson 8 participants will learn about

  • The risk factors associated with being born preterm
  • The additional resources needed to be prepared for a preterm delivery
  • Additional strategies to maintain the preterm baby’s body temperature
  • Additional considerations for managing oxygen in a premature baby
  • How to assist ventilation when a premature baby has difficulty breathing
  • Ways to decrease the chances of brain injury
  • Special precautions to take after resuscitating a premature baby


Lesson 9:  Ethics and Care at the End of Life

 In Lesson 9 participants will learn about

  • The ethical principles associated with starting and stopping neonatal resuscitation
  • How to communicate with parents and to involve them in ethical decision making
  • When it may be appropriate to withhold resuscitation
  • What to do when the prognosis is uncertain
  • How long to continue resuscitation attempts when the baby does not respond
  • What to do when a baby dies
  • How to help parents through the grieving process
  • How to  help staff through the grieving process


Neonatal Resuscitation Programme