Equipment Umbilical tape or 3-0 silk suture on straight or curved needle, antiseptic solution (povidone-iodine), sterile gauze pad, drapes, mask, gown, gloves, small curved hemostat Sterile scalpel and no 11 or 15 blade, iris scissors, 5Fr umbilical catheter threeway stopcock, 10-mL syringe with normal saline, infusing solution Procedure The umbilical vein is preferred for vascular access during neonatal resuscitation because the vessel is readily located and cannulated Catheterizing the umbilical vein is generally much easier than catheterizing the umbilical artery Place the newborn supine and restrain the extremities as necessary The newborn should be under a radiant warmer, and heart rate and pulse oximetry should be monitored throughout the procedure Prepare the equipment Attach a 5Fr umbilical catheter to a three-way stopcock and a saline-filled syringe Prime the catheter with normal saline Wearing mask, gown, and gloves, cleanse the umbilical cord and the abdomen from the xiphoid process to the pubic symphysis with povidone-iodine solution and allow to dry Hold the sterile umbilical catheter over the infant to measure the vertical distance from the lateral aspect of the clavicle to the umbilicus The catheter will be advanced into the vein 60% of this distance, beginning at the skin surface, to avoid direct infusion of medications into the liver At the base of the umbilical cord, loosely tie an umbilical tape or insert 3-0 silk suture around the cord to make a purse string Cut the cord to cm from the abdominal wall Locate the vein orifice (larger with thinner wall compared to the arteries) and remove any visible solid clot with fine forceps