Management of an Unexpected Delivery in the Emergency Department

Successful transition from the intrauterine to extrauterine environment is dependent on several significant physiologic changes that must occur within minutes of birth. Most infants effectively transition at delivery without requiring any special assistance. However, about 10% of infants will require some level of intervention, and 1% will require extensive resuscitative measures at birth. The focus of this article is on the preparation for and management of an unexpected delivery in the emergency department. We will highlight the unique aspects of newborn resuscitation, as well as recent changes to the Neonatal Resuscitation Program from the 2015 American Heart Association Guidelines.