PPV is indicated after performing the initial steps of resuscitation if the newly born still does not exhibit adequate respiratory effort (e.g., gasping or apneic) or if the heart rate is < 100 bpm. PPV is also indicated if the newly born does not achieve the predicted preductal oxygen saturation after receiving free-flow oxygen or CPAP.

Any time PPV is initiated, the neonatal provider calls for additional help if others are not already present to assist in other functions. Additional support is needed to:

• monitor heart rate response to PPV intervention
• monitor chest rise
• attach a pulse oximeter on an extremity with preductal circulation