If a newborn's pulse rate drops below 60 beats per minute at any time, or does not increase above 60 beats per minute after 30 seconds of assisted ventilations:

• A. Increase ventilation rate
• B. Begin chest compressions
• C. Call for help
• D. Stop resuscitation

Answer: (B)

When a newborn’s pulse rate stays below a critically low threshold after initial assisted ventilation, the priority is to improve circulation. A pulse under 60 beats per minute means the heart isn’t pumping effectively, so oxygen in the lungs isn’t reaching the brain and vital organs because perfusion is inadequate. Providing breaths alone won’t fix this; you need to generate artificial circulation to restore blood flow. That’s why the correct action is to begin chest compressions, using the neonatal CPR approach (a 3:1 compression-to-ventilation ratio) to raise the heart rate and improve perfusion while continuing ventilation. Calling for help is essential, but it does not directly address the immediate need to move blood through the body. Stopping resuscitation would be inappropriate in this scenario.