Resuscitate a cyanotic neonate with prostaglandin E1 — OSCE

A two-day-old term neonate on the postnatal ward has become centrally cyanotic with tachypnoea and poor perfusion. The pulse oximetry is 65 per cent in room air and does not rise with oxygen. The midwife calls you because a duct-dependent congenital heart lesion is suspected and echocardiography is at least an hour away. You have eight minutes to recognise the emergency, start the correct drug at the weight-based dose, anticipate the adverse effects, set the target saturation, and explain the plan to the nurse and to the family.