3h • Paramedic Talk
Neonatal SpO₂ and Tocolytics: Quick NREMT Study Guide
Neonatal SpO₂ After Birth
Newborns do not immediately have adult oxygen saturations after birth.
During normal transition, SpO₂ gradually rises over the first several minutes of life. This is why 90% at 1 minute is not expected in a normal newborn transition.
Preductal SpO₂
For neonatal resuscitation, SpO₂ is usually measured preductally.
Preductal location: Right hand or right wrist
Why right hand? The right hand reflects blood oxygen levels before blood passes through the ductus arteriosus, making it the preferred site during newborn resuscitation.
Target Preductal SpO₂ After Birth
Time After Birth
1 minute 60–65%
2 minutes 65–70%
3 minutes 70–75%
4 minutes 75–80%
5 minutes 80–85%
10 minutes or more 85–95%
These ranges are consistent with neonatal resuscitation oxygen-target references.
Tocolytics
What Are Tocolytics?
Tocolytics are medications used to slow or suppress uterine contractions.
They are used in preterm labor to delay delivery, usually for a short period of time.
Why Delay Preterm Labor?
The goal is usually to buy time for:
- Maternal transport to a higher-level OB/neonatal facility
- Steroids to improve fetal lung maturity
- Additional hospital-based OB management
Example
Terbutaline is an example of a tocolytic medication. It is a beta-agonist that can relax uterine smooth muscle and reduce contractions.
EMS/NREMT Key Point
Tocolytics do not “fix” preterm labor. They temporarily slow contractions to buy time.
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Neonatal SpO₂ and Tocolytics: Quick NREMT Study Guide
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