You are part of a team resuscitating a premature newborn. Shortly after birth, the baby developed apnea, followed by bradycardia. Positive-pressure ventilation with a bag-and-mask has not resulted in an improvement. You communicate to the team that you remember potential corrective steps using the acronym MR SOPA. Despite taking the first four corrective steps (M-R S-O), there is still no chest rise. You recommend that your team now consider the final two steps.

What are the final corrective steps in the acronym MR SOPA?

The final two steps of the MR SOPA procedure in neonatal resuscitation after the first four steps have been unsuccessful are to increase the pressure of the bag ventilation, and if that doesn’t work, considering an alternative airway.

Explanation:

The acronym MR SOPA is a mnemonic used in neonatal resuscitation procedures. It breaks down into M for Mask adjustment, R for Reposition airway, S for Suction mouth and nose, O for Open mouth, P for Pressure increase and A for Alternative airway. In your scenario, where the first four steps (M, R, S, O) have been unsuccessful, the final two steps that should be considered are: increasing the pressure in the ventilation bag (P), and if this doesn't work, using an alternative airway, such as endotracheal intubation or laryngeal mask airway (A).

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