Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first step to take for a newborn who is not breathing?

1. Start chest compressions

2. Administer five breaths via a bag-mask

3. Call for emergency assistance

4. Check the airway for obstructions

The correct answer is: Administer five breaths via a bag-mask

In the scenario where a newborn is not breathing, the first appropriate step is to administer five breaths via a bag-mask. This approach is crucial because after ensuring that the newborn is not breathing, immediate ventilation support is necessary to provide oxygen to the infant’s lungs. Newborns can experience respiratory distress due to various reasons, including eliciting an inadequate respiratory drive or airway obstruction, and providing breaths helps to address this issue quickly. When using a bag-mask, it is important to ensure a proper seal and deliver gentle breaths to avoid barotrauma, which can occur due to overventilation. This initial intervention is essential before proceeding to other techniques, such as calling for emergency assistance or performing chest compressions, as ensuring adequate ventilation is the priority in airway management for newborns. It is also critical to check the airway for obstructions, which should ideally be done simultaneously or in conjunction with the initial ventilation step. However, providing breaths takes precedence in the sequence of resuscitation efforts for newborns who are not ventilating effectively.