What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps?

The most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps is to administer positive-pressure ventilation that inflates the lungs.

After initial steps, Positive pressure ventilation (PPV) is indicated if a baby is gasping or if the heart is less than 100 beats per minutes.  

Positive-pressure ventilation may be administered if the baby is breathing and the heart beats is more than 100 per minutes.  

If the baby’s heart rate is not up to 60 beats per minutes after the administration of positive-pressure ventilation, then you should begin chest compression and continued positive-pressure ventilation but if the baby’s heart rate is still less than 60 beats per minutes after that, then intravenous epinephrine is highly recommended.

When Positive-pressure ventilation is applied, air is provided under pressure through a mechanical respirator, a machine that enhances or improves the exchange of air between lungs and the atmosphere.

The device is used to administer artificial respiration for a long a period of time in a situation where there is insufficient spontaneous ventilation.

It was invested by Philip Drinker and Louis Agassiz Shaw in 1927; it is made up of iron box, a bed and two vacuum cleaners.  

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