A new term neonate is limp and apneic after birth. What is the priority intervention?

In the scenario of a new term neonate who is limp and apneic after birth, the priority intervention is to initiate positive pressure ventilation. This is crucial because the immediate threat to the neonate's life is the lack of adequate respiratory effort, which can lead to inadequate oxygenation and potential brain injury or death if not promptly addressed.

Positive pressure ventilation provides airflow into the lungs, which can help establish functional residual capacity and facilitate gas exchange. This step is vital in the resuscitation process for newborns, especially those who are not breathing spontaneously. The goal of this intervention is to stabilize the infant's condition by ensuring adequate oxygen delivery to vital organs and restoring normal respiratory function.

Other interventions, such as suctioning the oropharynx or initiating chest compressions, may be necessary depending on the assessment of the neonate's heart rate and airway patency, but they are not the immediate priority in a scenario primarily characterized by apneic status. Vascular access is also essential for administering medications or fluids if needed later in the resuscitation process but is secondary to restoring breathing through positive pressure ventilation. Therefore, initiating positive pressure ventilation is recognized as the most critical first step in managing a limp and apneic neonate.