What action should be taken if the heart rate does not improve after the first 15 seconds of PPV?

When a newborn's heart rate does not improve following the first 15 seconds of positive pressure ventilation (PPV), it is crucial to reassess the ventilation technique employed. This step is vital because ineffective ventilation can result in inadequate oxygenation and may fail to stimulate an appropriate heart rate response.

By evaluating the technique, healthcare providers can identify issues such as improper mask seal, inadequate airway management, or incorrect ventilation rates and volumes. Ensuring that the airway is patent and that ventilation is effective can significantly enhance the newborn's oxygenation, potentially leading to an improved heart rate. This assessment may include checking the size and fit of the mask, ensuring the endotracheal tube is properly placed if used, and confirming that the ventilatory pressures applied are sufficient without causing daño.

In contrast, stopping PPV immediately would interrupt a potentially lifesaving intervention without assessing its effectiveness first. Beginning chest compressions would only be indicated if the heart rate remains below 60 beats per minute despite effective ventilation, which is not the first course of action in this scenario. Initiating supplemental oxygen could also be important, but addressing the ventilation technique takes precedence to ensure that basic resuscitative measures are functioning correctly.