NRP Neonatal Resuscitation Program

The Neonatal Resuscitation Program® (NRP®) course conveys an evidence-based approach to care of the newborn at birth and facilitates effective team-based care for healthcare professionals who care for newborns at the time of delivery. NRP utilizes a blended learning approach, which includes online testing and hands-on case-based simulation/debriefing that focus on critical leadership, communication, and team-work skills.​​

The 8th Edition Neonatal Resuscitation Program (NRP) is an educational program of the American Academy of Pediatrics and is jointly sponsored with the American Heart Association (AHA). The course has been designed to teach hospital staff who care for newborns at the time of delivery, including physicians, nurses and respiratory therapists. Since the inception of the NRP in 1987, over 3 million individuals in the United States and a countless number of individuals abroad have been trained in NRP.

The NRP Provider Course introduces the concepts and basic skills of neonatal resuscitation. It is designed for health care professionals involved in any aspect of neonatal resuscitation, including physicians, nurses, advanced practice nurses, nurse midwives, licensed midwives, respiratory care practitioners, and other health care professionals who provide direct care during neonatal resuscitation.

Participants must complete the online test at www.aap.org/nrp and choose the 8th Edition NRP Provider Course for $45. Once the online Part 1 portion is complete, you will need to attend the in person hands on portion of the course. The cost of this course is $275 and includes the 8th Edition NPR Textbook PDF.

CONTINUING EDUCATION

Participants will receive one continuing education credit for each Neonatal Resuscitation Program online lesson completed. The American Academy of Pediatrics is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American Midwifery Certification Board accepts continuing education units approved by the ACCME (Accreditation Council for Continuing Medical Education) Category 1, and the AMA (American Medical Association ) PRA Category 1.

Certified Nurse Midwives may receive a maximum of 9 hours of Category 1 Credit for completing this program. This activity is designated for 9.00 AMA PRA Category 1 Credit(s).

The American Academy of Pediatrics has developed numerous resources for the students including several learning station videos. 

CPAP in the Delivery Room

Positive-Pressure Ventilation with Face Mask/Free Flow Oxygen and Orogastric Tube Placement

Laryngeal Mask

Chest Compressions

Performing and Assisting with Endotracheal Intubation

3x3 Method for Placing Emergency Umbilical Venous Catheters

PPV Terminology and Devices

Epinephrine and Volume Expanders

Intraosseous Needle Insertion

MR. SOPA

Positive-Pressure Ventilation with Flow-Inflating Bag

Pulse Oximetry

The Neonatal Resuscitation Program® (NRP®) course conveys an evidence-based approach to care of the newborn at birth and facilitates e​ffective team-based care for healthcare professionals who care for newborns at the time of delivery. NRP utilizes a blended learning approach, which includes online testing, online case-based simulations, and hands-on case-based simulation/debriefing that focus on critical leadership, communication, and team-work skills.​​

Foundations of Neonatal Resuscitation

Key Points

- Most newborns make the transition to extrauterine life without
intervention.

- Before birth, pulmonary blood vessels in the fetal lungs are tightly
constricted, and the alveoli are filled with fluid, not air.

- Newborn resuscitation is usually needed because of respiratory
failure.

- The most important and effective step in neonatal resuscitation is
to ventilate the baby's lungs.

- Very few newborns will require chest compressions or medication.

- Teamwork, leadership, and communication are critical to
successful resuscitation of the newborn.

The Neonatal Resuscitation Program

The Neonatal Resuscitation Program (NRP®) will help you learn the
cognitive, technical, and teamwork skills that you need to resuscitate
and stabilize newborns. Most newborns make the transition to
extrauterine life without intervention. Within 30 seconds after
birth, approximately 85% of term newborns will begin breathing.
An additional 10% will begin breathing in response to drying and
stimulation. To successfully transition, approximately
• Five percent of term newborns will receive positive-pressure
ventilation (PPV).
• Two percent of term newborns will be intubated.
• One to 3 babies per 1,000 births will receive chest compressions or
emergency medications.

 The likelihood of requiring these lifesaving interventions is higher
 for babies with certain identified risk factors and those born before
 full term. Even though the majority of newborns do not require
 intervention, the large number of births each year means that timely
 intervention can save many newborn lives. Because the need for
 assistance cannot always be predicted, health care providers need to be
 prepared to respond quickly and efficiently at every birth.
 During your NRP course, you will learn how to evaluate a newborn,
 make decisions about what actions to take, and practice the steps
 involved in resuscitation. As you practice together in simulated cases,                             your team will gradually build proficiency and speed. The most                               gratifying aspect of providing skillful assistance to a compromised                                 newborn is that your efforts are likely to be successful. The time that                              you devote to learning how to resuscitate newborns is time very well spent.

Why do newborns require a different approach to
resuscitation than adults?

Most often, adult cardiac arrest is a complication of coronary artery
disease. It is caused by a sudden arrhythmia that preve11ts the heart
from effectively circulating blood. As circulation to the brain decreases,
the adult victim loses consciousness and stops breathing. At the time
of arrest, the adult victim's blood oxygen and carbon dioxide ( C0 2)
content is usually normal and the lungs remain filled with air. During
adult resuscitation, chest compressions maintain circulation until
electrical defibrillation or medications restore the heart's function.

In contrast, most newborns requiring resuscitation have a healthy
heart. When a newborn requires resuscitation, it is usually because
respiratory failure interferes with oxygen and C0 2 exchange.
• Before birth, fetal respiratory function is performed by the placenta
instead of the fetal lungs. When the placenta is functioning
normally, it transfers oxygen from the mother to the fetus and
carries C0 2 away from the fetus to the mother. A healthy fetus
makes breathing movements, which are important for normal lung
growth.
• When placenta! respiration fails, the fetus receives an insufficient
supply of oxygen and C0 2 cannot be removed. Acid increases in
the fetal blood as cells attempt to function without oxygen and C0 2
accumulates.
• Fetal monitoring may show a decrease in activity, loss of heart rate
variability, and heart rate decelerations. If placenta! respiratory
failure persists, the fetus will make a series of reflexive gasps
followed by apnea and bradycardia.
• If the fetus is born in the early phase of respiratory failure, tactile
stimulation may be sufficient to initiate spontaneous breathing and
recovery. If the fetus is born in a later phase of respiratory failure,
stimulation alone will not be sufficient and the newborn will require
assisted ventilation to recover. The most severely affected newborns
may require chest compressions and epinephrine. At the time of
birth, you may not know if the baby is in an early or a late phase of
respiratory failure.