What immediate action should be taken if a newborn does not improve after face-mask ventilation?

When a newborn shows no improvement after face-mask ventilation, the most appropriate immediate action is to secure the airway more effectively. Inserting an endotracheal tube or a laryngeal mask is crucial in this scenario because it allows for a more controlled and efficient delivery of oxygen and ventilation directly into the lungs. This approach is particularly important if the newborn is unable to maintain proper oxygenation and ventilation with simple mask techniques alone, either due to anatomical issues or severe respiratory distress.

Increasing the ventilation pressure might provide temporary relief; however, if the underlying airway management is inadequate, it won't address the root of the problem. Administering supplemental oxygen can help improve oxygen levels but will not resolve issues related to poor ventilation or airway management. Lastly, performing chest compressions may be warranted if the heart rate drops significantly, but this should be considered only after ensuring an adequate airway and when there's evidence of inadequate circulation.