Preterm newborns are the babies most likely to require resuscitation at birth. Newborns < 32 weeks gestation require additional supplies and equipment to keep warm. The team must prepare a polyethylene wrap and a thermal mattress. Radiant warmers with a temperature control device are highly recommended. These warmers have servo-controllers that adjust the temperature based on the baby’s body temperature. 

While ventilating the preterm infant, an oxygen blender is used to titrate the oxygen concentration carefully. A pulse oximeter with a sensor that fits the preterm newborn’s right hand or wrist is used to measure the SpO₂. The PPV device must be capable of providing positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) as well as positive pressure breaths. 

When gathering equipment, the team needs to select laryngoscope blades size O and size OO, endotracheal tubes sizes 2.5 and 3.0, and an appropriately sized resuscitation mask. Preterm newborns < 30 weeks gestation may also need surfactant replacement therapy. The team should have a 3-lead ECG cardiac monitor to measure the heart rate promptly and accurately.

After stabilization in the delivery room, the preterm newborn should be transported to the neonatal intensive care unit in a temperature-controlled incubator with blended oxygen and a pulse oximeter monitor.

Infant in an incubator.