What should be done if a newborn's pulse rate is 50 beats/min after initial resuscitation steps?

When a newborn's pulse rate is measured at 50 beats per minute after initial resuscitation steps, the appropriate course of action is to begin chest compressions if the heart rate remains below 60 bpm. This is critical because a pulse rate under 60 in a newborn indicates severe bradycardia, which could lead to inadequate cardiac output and potential cardiac arrest.

In the context of neonatal resuscitation, guidelines emphasize the importance of chest compressions when the heart rate is below this threshold. This is essential for maintaining circulation and ensuring that vital organs receive adequate blood flow and oxygen until more advanced interventions can be implemented or the heart rate improves.

In contrast, while starting positive pressure ventilations is important for treating respiratory issues, their efficacy will be limited if the heart rate remains critically low. Tactile stimulation may help in some instances to stimulate a newborn's heart rate, but it is typically not considered sufficient in cases where the heart rate is significantly low after initial resuscitation efforts. Therefore, the focus should shift to more effective measures like chest compressions when the heart rate does not improve.