1. Assess at time of 10 minute APGAR
PILOT Care Pathway for the Assessment of Term (>37 weeks) Babies at Delivery
Assess at time of 10 minute APGAR
Keep skin-to-skin with mother
Confirm RAG risk category
Follow pathway and review accordingly
Age
SpO2
2 min
60%
3 min
70%
4 min
80%
5 min
85%
10 min
90%
15 min
≥95%
Signs of Respiratory Distress including:
Cyanosis
Grunting respirations
Subcostal or intercostal recessions
Tracheal Tug
Nasal Flare
Tachypnoea (respiratory rate >60) No
Yes
Pre-ductal oxygen saturations
(right hand)
<90% at 10 minutes
<95% at 15 minutes
>90% at 10 minutes
>95% at 15 minutes
1) Consider NERT call (2222)
2) Move to resuscitaire under radiant heat and make sure hat on (RAG as applicable)
3) Give 5cm PEEP via facemask and oxygen to maintain adequate saturations (see Box)
4) If NERT call not required, call Neonatal SHO/ANNP (bleep 3217) for urgent review – SHO/ANNP to see within 10 minutes
Yes
Persistent grunting or clinical concern No
1) Keep baby warm skin-to-skin with mum
2) If intermittent grunting only  Confirm RAG risk category and ensure appropriate pathway actions.
3) Inform neonatal SHO/ANNP (bleep 3217)
4) Reassess in 20 minutes
Reassess at 30 minutes of age – see over leaf
H. Daniels, C. Lea, C. Warren, A. Collinson 2018

2. H. Daniels, C. Lea, C. Warren, A. Collinson 2018
Reassess any baby with resolved or ongoing signs of respiratory distress at 30 minutes of age
Signs of Respiratory Distress including:
Cyanosis
Grunting respirations
Subcostal or intercostal recessions
Tracheal Tug
Nasal Flare
Tachypnoea (respiratory rate >60)
Pre-ductal oxygen saturations
(right hand)
<95% OR ongoing respiratory distress
>95%
AND no signs of respiratory distress
1) Consider NERT call (2222)
2) Move to resuscitaire under radiant heat and make sure hat on (RAG as applicable)
3) Give 5cm PEEP via facemask and oxygen to maintain adequate saturations (see Box)
4) If NERT call not required, call Neonatal SHO/ANNP (bleep 3217) for urgent review – SHO/ANNP to see within 10 minutes
Keep skin-to-skin with mother
Confirm RAG risk category
Follow pathway and review accordingly
H. Daniels, C. Lea, C. Warren, A. Collinson 2018