You delivered a newborn with shallow breathing, a heart rate of 58, and peripheral cyanosis. What is the first action you should take?

In the scenario of a newborn presenting with shallow breathing, a heart rate of 58, and peripheral cyanosis, the immediate focus should be on assessing and ensuring the effectiveness of the circulation. The heart rate of 58 indicates bradycardia, which is a critical condition in newborns.

When faced with such a low heart rate, the guidelines stipulate that if the heart rate is below 60 beats per minute, chest compressions should be initiated if appropriate ventilation does not resolve the bradycardia. Chest compressions are necessary to establish and maintain adequate blood flow to vital organs. This action is crucial in supporting the newborn’s circulatory system, especially in the face of respiratory distress, as effective compressions can help improve perfusion and potentially increase heart rate.

Addressing other interventions like oxygen therapy, administering epinephrine, or providing warmth comes after ensuring the newborn has adequate circulation through compressions if needed. This sequence of actions is vital in neonatal resuscitation to effectively manage and stabilize the infant.