It is essential that a veterinary nurse is familiar with the practical knowledge required in order to revive a neonate following birth by Caesarean section, since survival of the new-born is dependent on the rapid onset of spontaneous respiration. In the Practical Examination you may be presented with a soft toy or beanbag representing the neonate and asked to demonstrate how you would perform resuscitation.

1. As with all emergencies; remember the first priority is the patient's airway. Holding the neonate in a warm towel, clear the mouth, nose and pharynx of any attached foetal membrane, fluid and mucus. Using your fingers is the easiest method and does not require any equipment, although a simple suction device such as a syringe may also be utilised.
2. Next hold the neonate with the head lower than the hind limbs and supporting the head with fore-finger and thumb, swing from side to side or up and down. This will dislodge any fluid that may have accumulated lower down in the respiratory tract. Gently use your fingers to remove.
3. Briskly rub the chest of the neonate. This provides warmth and helps to dry the new-born in addition to stimulating respiration.
4. If the neonate is hypoxic, administer oxygen via a mask. In addition, blowing gently into the mouth and nostrils may encourage respiration.
5. Neonates are more resistant to hypoxia than adults, and natural methods should be used to stimulate the respiratory system during the first minute. If apnoea persists for more than one minute, commence artificial respiration with external cardiac massage (closed chest resuscitation) if required. Massage the heart by compressing the ribs at a rate of 80-100 compressions per minute between thumb and forefinger. Deliver 2-3 lung inflations for every 15 chest wall compressions.
6. Dopamine (Dopram drops) may be used if myocardial depression is present. Place one drop on the neonate's tongue and continue resuscitation.
7. If normal respiration is not present after 2-3 minutes, the neonate's chances of survival are poor. If normal spontaneous respiration results, place the neonate in an oxygen rich incubator at 30°C. The neonate may be dried with a hair drier, but take care not to overheat. Remember that new-born puppies and kittens are poikilothermic and are unable to regulate their own body temperature; this means that their body temperature varies with the ambient temperature. Try to provide humidification to the area.
8. Monitor respiratory rate, heart rate and mucous membrane colour.