If a baby has normal vitals but central cyanosis, what should you do?

• A. Start full CPR
• B. Blow-by oxygen
• C. Give IV fluids
• D. Place in Trendelenburg

Answer: (B)

Central cyanosis means the blood is not carrying enough oxygen, even if the baby’s heart rate, breathing rate, and perfusion appear okay. The immediate goal is to improve oxygenation, not to perform CPR. Providing supplemental oxygen directly to the infant’s face with a blow-by approach delivers high-concentration oxygen without a tight mask seal, which is well tolerated and effective in stabilizing oxygen levels in a calmly presenting newborn. If the cyanosis improves with this therapy, continue monitoring and support. Starting CPR is unnecessary here because there’s no indication of arrest or severe compromise. IV fluids aren’t the first step in a stable cyanotic infant, as fluid therapy is reserved for shock or dehydration. Trendelenburg positioning isn’t recommended and doesn’t correct the hypoxemia.