I am sure you ALL have heard this acronym with your Neonatal Resuscitation Program (NRP) course! NRP emphasizes that when the baby isn’t responding to your resuscitation efforts, use MR. SOPA as your corrective steps for Positive Pressure Ventilation (PPV):
M — Mask Adjustment — Reapply the mask using the 2-hand technique. Ensure it is the right size and fit
R — Reposition airway — Place head neutral or slightly extended
S — Suction mouth and nose — Use a bulb syringe or suction catheter
O — Open mouth — Open the mouth and lift the jaw forward when bagging
P — Pressure increase — Increase pressure gradually in 5-10 cm H2O increments until visible chest rise is noted, max PIP of 40.
A — Alternative Airway — If all else fails, place an ETT or LMA as your final intervention