You have just assisted in the delivery of a 34-weeks-gestation infant in the office of a methadone clinic. The mother had been in the clinic with her boyfriend, who was there for his methadone. The infant has a 5-minute APGAR score of 5 after drying, warming, suctioning, stimulating, and providing bag-valve-mask ventilations. Your partner advises that the mother denies narcotic use but is lethargic and has constricted pupils. Which of the following is the most appropriate action to take at this point?
A) Continue bag-valve-mask ventilations, secure intravenous access, administer 0.2 mg of naloxone, reassess, and prepare for transport to a NICU regardless of improvement.
B) Intubate the trachea, continue ventilations, contact medical control for consultation concerning intravenous access and administration of naloxone, and prepare to transport to a NICU.
C) Continue bag-valve-mask ventilations, perform chest compressions for 1 minute, reassess, establish intravenous access, continue chest compressions if the heart rate remains less than 100, consult with medical control concerning administration of naloxone, and transport destination.
D) Intubate the trachea, administer 0.4 mg of naloxone through the endotracheal tube, ventilate, reassess, and prepare to transport to a NICU if no improvement.
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