Singapore Neonatal Resuscitation Guidelines 2021 - Neonatal resuscitation recommendations and practice updates

Sep 30, 2026

Uploaded by Jake

Neonatal resuscitation is presented as a coordinated, team-based sequence of timed, sequential steps designed to support transitional physiology and improve perinatal and neonatal outcomes. The revised Singapore 2021 guidelines update earlier 2016 guidance using the ILCOR 2020 Consensus on Science and Treatment Recommendations, and align with the American Heart Association and European Resuscitation Council newborn life support recommendations. Local applicability was derived after the SRFAC Neonatal Subgroup appraised current evidence for Singapore clinical practice.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background and Introduction

Anticipation and Preparation for Resuscitation

Umbilical Cord Management

Delayed cord clamping

Review Article Singapore Med J 2021; 62(8): 404-414 [https://doi.org/10.11622/smedj.2021110](https://doi.org/10.11622/smedj.2021110) Singapore Neonatal Resuscitation Guidelines 2021 Agnihotri Biswas1,2,3, *, MBBS, MRCPCH, Selina Kah Ying Ho2,4,5,6, *, MBBS, MMed, Wai Yan Yip2,5,6,7, *, MBBS, MRCPCH, Khadijah Binti Abdul Kader1, MBBS, MRCPCH, Juin Yee Kong2,5,6,7, MD, FAAP, Kenny Teong Tai Ee3,8, MBBS, MRCP, Vijayendra Ranjan Baral2,4,5,6, MBBS, FRCPCH, Amutha Chinnadurai1,2,\#, MBBS, MRCPCH, Bin Huey Quek2,3,5,6,7,\#, MRCP, MMed, Cheo Lian Yeo2,3,4,5,6,\#, MBBS, MMed | ABSTRACT Neonatal resuscitation is a coordinated, team-based series of timed sequential steps that focuses on a transitional physiology to improve perinatal and neonatal outcomes. The practice of neonatal resuscitation has evolved over time and continues to be shaped by emerging evidence as well as key opinions. We present the revised Neonatal Resuscitation Guidelines for Singapore 2021. The recommendations from the International Liaison Committee on Resuscitation Neonatal Task Force Consensus on Science and Treatment Recommendations (2020) and guidelines from the American Heart Association and European Resuscitation Council were compared with existing guidelines. The recommendations of the Neonatal Subgroup of the Singapore Resuscitation and First Aid Council were derived after the work group discussed and appraised the current available evidence and their applicability to local clinical practice. | | | --- | --- | | Keywords: neonatal resuscitation, newborn resuscitation, Singapore Resuscitation and First Aid Council (SRFAC) guidelines for resuscitation 2021 | | | BACKGROUND AND INTRODUCTION
Resuscitation at birth requires a team of providers with different skill sets to communicate, collaborate and perform the necessary steps efficiently, guided by a standardised protocol and uniform practice guidelines. The majority of preterm newborns require some form of resuscitation and/or stabilisation during transition to extrauterine life. In comparison, about 10% of term newborns require stimulation to initiate breathing, 5% require positive pressure ventilation (PPV) before spontaneous breathing is established, 2% require intubation for longer respiratory support, 0.1% require cardiac compressions and 0.05% require adrenaline.(1-4)
This review by the Neonatal Subgroup of the Singapore Resuscitation and First Aid Council (SRFAC) is an update of the previous Singapore Neonatal Resuscitation Guidelines (2016)(5) and draws from the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science with Treatment Recommendations (CoSTR), the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care and the European Resuscitation Council newborn life support (2021) recommendations. (6-8) This guideline applies to newborns transitioning to extrauterine life irrespective of their place of birth and neonates who have completed newborn transition and require resuscitation during the initial hospitalisation. The key highlights are presented in Box 1 and in the discussion on treatment recommendations and practice guidelines, which are organised in alignment with the newborn resuscitation algorithm (Fig. 1) . | ANTICIPATION AND PREPARATION FOR RESUSCITATION
Identification of antepartum and intrapartum risk factors (Box 2) helps to anticipate the need for resuscitation at birth. Resuscitation may not be anticipated at all times; hence, it is important to be able to mobilise a team capable of advanced resuscitation at short notice. The topic on prediction of respiratory support in the delivery room was reviewed in 2020.(6) There was no new evidence to support a change in the recommendations from the 2010 ILCOR guidelines.(9,10)
Recommendations on anticipation and preparation
• Anticipate resuscitation needs and prepare in advance.
• The environment should be warm, well-lit and draught-free

FAQs

What is the purpose of the Singapore Neonatal Resuscitation Guidelines 2021?

They provide a coordinated, team-based approach for neonatal resuscitation during the transition to extrauterine life, aiming to improve perinatal and neonatal outcomes.

Which international evidence was used to revise the 2021 recommendations?

The guideline updates were based on the ILCOR 2020 Consensus on Science and Treatment Recommendations and were compared with guidance from the American Heart Association and the European Resuscitation Council.

To which newborns does the guideline apply?

It applies to newborns transitioning to extrauterine life regardless of birthplace and to neonates who have completed newborn transition but require resuscitation during initial hospitalisation.

Sep 30, 2026

Uploaded by Jake