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Revive or Resuscitate Newborn Foal

A normal, vigorous newborn tries to rise within a few minutes of birth, are standing within one hour, and are nursing within 2 hours. A normal respiratory rate in a newborn foal is 60-70 breaths per minute. A normal heart rate in a newborn foal is 60-120 beats per minute.

In some cases a newborn foal is weak and depressed. These foals typically have a low heart rate, breath slowly or struggle for breath, and may lie on their side or not raise their heads. These foals usually have poorly oxygenated blood due to a difficult birthing process. The reality is that these foals will not likely survive.

However, there is a window of opportunity for you to try and help the foal. Ideally your vet is present and can provide emergency medical treatment, but in some cases, a weak foal die before they arrive.

Procedure

Using a dry soft towel gently clear the debris and mucous from the foal's mouth and nostrils. If there is excessive mucus, you can also use a bulb syringe to do this but this is usually not necessary.

Spend about 30 seconds rubbing the foal to try to invigorate it. If the foal is unresponsive, then attempt to resuscitate the foal by mouth or using a resuscitator.

Begin by laying the foal on its side, extend and straighten the neck as much as possible. If the neck is flexed, the air tends to go into the stomach instead of the lungs.

By Mouth: To give mouth-to-mouth resuscitation, plug the down nostril with your right hand, and breathe into the uppermost nostril, as you watch the foal's chest. Exhale enough to get the foal’s chest to rise noticeably with each breath.

By Mask: Place the mask of the foal respirator over the foal's muzzle and depress the cylinder. Watch the foal's chest for expansion and deflation. Do this every 2-3 seconds for 1 minute.

Check for spontaneous breathing and heart rate every 30-60 seconds, but do not stop for longer than 10 seconds to assess the foal. Ventilation can be stopped when the foal’s heart rate is above 80 beats per minute and the foal is breathing spontaneously at least 40 breaths per minute.

Chest Compression: As in human CPR, chest compressions are rarely successful and can further injure the foal. That said, they can be helpful if the foal’s heart rate is less than 40 beats per minute, and after 1 minute of ventilation has been performed. Quickly run your fingers along the foal’s ribcage to feel for fractured ribs before beginning. Do not perform compressions if the foal’s ribs feel fractured.

Place the heel of one hand directly behind the elbow, just below where you would tighten a girth. Place the other hand on top of the first hand. Compress the heart 1.5-2 times per second for 1-2 minutes. Then stop and reevaluate pulse, heart rate, breathing and responsiveness. Repeat.

Tips for safety & Success

Generally, foals breath better when they are propped on their chest. However, attempts at resuscitation usually require that the foal is on its side. The goal of resuscitation is to restore a strong heart beat, respiration and brain function. Remember the ABC's of resuscitation. Airway, Breathing, Circulation in that order.

Only intervene at all if the foal seems abnormal to you. Attempt resuscitation if the foal is not breathing, gasping for breath, breathing very slowly, or if the foal's heart rate is less than 40 BPM.

Gentle rubbing of the foal is helpful to stimulate it, but do not swing a newborn by the hind legs. The rationale for this is that it will clear fluid from the foal's lungs. However, swinging a foal by the hind legs is not necessary and the procedure can injure or kill an already weak foal.

Keep in mind that foals that require intensive resuscitation at birth will probably not survive. This monumental effort is just the beginning. The foal will likely experience other problems and should be transported to a hospital facility as soon as possible.

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Author: Doug Thal DVM Dipl. ABVP

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