What is the next step after administering PPV to a newborn with a heart rate of 70 bpm and no increase?

In the scenario where a newborn is administered positive pressure ventilation (PPV) and the heart rate remains low at 70 bpm without an increase, the appropriate next step involves initiating more advanced resuscitative measures.

When a newborn's heart rate is below 60 bpm despite effective PPV for a sufficient duration (typically around 30 seconds), it indicates that the baby is not responding adequately to the initial ventilatory support. In this situation, advanced measures such as intubation are required to secure the airway and ensure the delivery of effective ventilation. Intubation allows for better control over air delivery and can markedly improve oxygenation, which is critical in reviving the newborn.

Administering PPV is generally the first line of treatment for newborns with apnea or bradycardia, but when there is no heart rate improvement, further interventions are necessary, making intubation the prioritized step in this clinical situation.

Other options like continuing PPV alone would not be sufficient if there’s no response, while checking for a pulse does not address the issue needing resolution. Chest compressions would be appropriate only if the heart rate falls below 60 bpm and remains unresponsive to PPV, but given this specific heart rate scenario, intub