A newborn exhibits a heart rate of 50/min and is limp after delivery. What intervention should be initiated?

In the scenario where a newborn has a heart rate of 50 beats per minute and is exhibiting limpness after delivery, the appropriate intervention is positive pressure ventilation. A heart rate below 60 beats per minute is critically low and indicates the need for immediate resuscitative measures to ensure adequate oxygen delivery to the tissues.

Positive pressure ventilation is necessary in this situation to assist the newborn’s breathing, especially since the infant is not actively breathing and has a very low heart rate. This intervention helps to ensure that the lungs are inflated effectively and that adequate ventilation occurs, which can improve oxygenation and subsequently stimulate an increase in heart rate.

While tactile stimulation is often used to encourage a newborn to take their first breath, it is typically not sufficient when the heart rate is critically low and significant respiratory support is needed. Similarly, blow-by oxygen may provide some supplemental oxygen, but it is inadequate for an infant with such a low heart rate and who is limp. Chest compressions would only be initiated if the heart rate does not improve with appropriate ventilation efforts, thus reinforcing that positive pressure ventilation is the immediate priority in this critical situation.