It is very difficult to complete all the steps of resuscitation in 10 minutes. Should we always stop at 10 minutes after birth if there is no heartbeat or respiration?
Ideally, a practitioner with the skills and scope of practice to make a decision to discontinue resuscitation should make this decision. Completing all the steps of resuscitation, including volume expansion, is likely to take more than 10 minutes. This recommendation may be interpreted to mean that at least 10 minutes have elapsed and AFTER full resuscitation has been implemented, including effective ventilation and volume expansion (this should require 10 to 20 minutes, timed from initial evaluation). We suggest that once 10 minutes of full resuscitation has demonstrated to be ineffective (absent heart beat) the designated practitioner institute discussion with the team and parents regarding the benefit or futility of continuing resuscitative measures. There is always the option to consult with a specialist or referring centre while resuscitation is ongoing.
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