Southern California EMS Midterm Practice Test

When a newborn’s heart rate stays low after you’ve started effective ventilation, the next step is to provide chest compressions with ventilation in a 3:1 ratio. This approach targets both perfusion and oxygenation: the compressions boost blood flow to vital organs, while the ventilations continue to deliver oxygen to the lungs and blood. In neonatal resuscitation, a heart rate below about 60 beats per minute despite adequate ventilation signals that circulation is insufficient, so initiating CPR with a 3:1 compression-to-ventilation ratio is indicated. Raising the ventilation rate alone to 80–100 breaths per minute won’t correct the poor circulation and can cause issues like gastric distension and reduced venous return. Epinephrine is a later consideration, used if the heart rate remains under 60 after CPR has begun, and stopping to transport isn’t appropriate while actively resuscitating. So the best action is to start chest compressions at the 3:1 ratio.