It is highly suspected that a newborn has aspirated meconium. What actions should be immediately undertaken?

1. Instill exogenous surfactant.
2. Suction out the meconium.
3. Begin mechanical ventilation.
4. Intubate the infant.
a. 2, 4
b. 1, 2
c. 2, 3, 4
d. 1, 2, 3, 4

A
If a newborn has aspirated meconium, it must be immediately removed. This is best done by inserting an oral endotracheal tube into the newborn's trachea and passing a suction catheter through the tube to suction out the meconium. In most cases, this will eliminate the need for mechanical ventilation. Some infants with severe meconium aspiration will need to be mechanically ventilated and given exogenous surfactant.