In neonatal resuscitation, what is done if heart rate remains below 100 after initial ventilation?

In the context of neonatal resuscitation, if an infant's heart rate remains below 100 beats per minute after initial ventilation attempts, administering epinephrine is the appropriate course of action. This is based on established guidelines which emphasize that when adequate ventilation has not resulted in an increase in heart rate, the next step is to consider the use of epinephrine.

Epinephrine works as a potent stimulant for cardiac activity. It can help to improve heart rate and enhance myocardial contractility when the infant is experiencing bradycardia (a slow heart rate). This intervention is critical because it can provide the necessary cardiovascular support to restore normal heart function during resuscitation efforts.

The other options, while they may be components of overall resuscitation protocols, do not directly address the need for immediate pharmacological intervention in the case of persistent bradycardia post-ventilation. For example, simply providing oxygen may not be effective if the heart rate does not improve due to underlying issues. Additionally, chest compressions are recommended only if the heart rate is below 60 beats per minute, and repositioning the infant might help if there is an obstruction or if adequate ventilation is not being achieved, but it does not address the immediate issue of a low