If a newborn's heart rate remains less than 60 bpm after administering epinephrine, what volume of normal saline flush is recommended?

In the context of neonatal resuscitation, if a newborn's heart rate remains below 60 beats per minute (bpm) despite the administration of epinephrine, it is critical to ensure that the medication has been properly delivered into the circulation. A saline flush helps to facilitate this. The recommended volume of normal saline flush to assist in this situation is typically 3 mL. This volume is sufficient to effectively clear the medication from the catheter or line and ensure that it enters systemic circulation promptly.

Using a flush volume that is too small may not adequately ensure that the epinephrine reaches the heart and central circulation, potentially delaying the desired increase in heart rate. Conversely, too large a volume may not be necessary and could contribute to fluid overload. Therefore, the recommendation of 3 mL strikes a balance that is appropriate for assisting with the efficacy of the medication while minimizing potential complications.