1. Birth: term? good tone? breathing/crying? Yes → stay with mother, delayed cord clamping (≥30–60 s), dry, skin-to-skin.
2. No → initial steps (first 60 s): warm, dry, stimulate, position airway, suction only if obstructed. Non-vigorous meconium baby: no routine intubation/tracheal suction.
3. Apnea/gasping or HR <100 → PPV 40–60/min, SpO2 probe (right hand), consider ECG. O2: 21% if ≥35 wk, 21–30% if <35 wk.
4. HR not rising → MR SOPA (Mask, Reposition, Suction, Open mouth, Pressure up, Alternative airway).
5. HR <60 after 30 s of PPV that moves the chest (ideally via ETT/laryngeal mask) → compressions 3:1 (90 compressions + 30 breaths/min), O2 100%, UVC.
6. HR still <60 after 60 s of compressions → epinephrine IV/IO 0.02 mg/kg (range 0.01–0.03; 0.1 mg/mL) every 3–5 min; ETT 0.1 mg/kg while access obtained.
7. Suspect hypovolemia (pale, cord accident) → NS or O-negative blood 10 mL/kg over 5–10 min. Consider pneumothorax.
8. Breathing but labored or persistent cyanosis → CPAP and pulse oximetry.

1. Unresponsive, no normal breathing, no pulse (≤10 s check) → start CPR, give O2, attach monitor/defibrillator. Rate 100–120/min, depth ≥1/3 AP chest (≈4 cm infant, 5 cm child); 30:2 single rescuer, 15:2 two rescuers.
2. Rhythm VF/pulseless VT → shock 2 J/kg → resume CPR immediately for 2 min; obtain IV/IO.
3. Still shockable → shock 4 J/kg → CPR 2 min + epinephrine 0.01 mg/kg IV/IO (0.1 mL/kg of 0.1 mg/mL, max 1 mg), repeat every 3–5 min. Consider advanced airway (then 1 breath every 2–3 s, continuous compressions).
4. Still shockable → shock ≥4 J/kg (max 10 J/kg or adult dose) → CPR + amiodarone 5 mg/kg bolus (repeat up to 3 doses) or lidocaine 1 mg/kg.
5. Treat reversible causes throughout (H's and T's). Organized rhythm → check pulse → ROSC care.

ROSC: SpO2 94–99%, normocapnia, avoid hypotension and fever, check glucose, 12-lead ECG.

1. No pulse → CPR (high quality, minimal interruptions), O2, monitor.
2. Rhythm asystole or PEA (organized rhythm without pulse) → no shock.
3. Epinephrine ASAP: IV/IO 0.01 mg/kg (0.1 mL/kg of 0.1 mg/mL, max 1 mg), repeat every 3–5 min. ETT dose 0.1 mg/kg only if no IV/IO.
4. CPR 2 min → rhythm check. Becomes shockable → shockable pathway. Organized rhythm → pulse check.
5. Look for and treat reversible causes.

Trauma PEA: think hypovolemia, tension pneumothorax and tamponade first.