What should be the first intervention for a preterm baby that is apneic with fluid in the airway?

Providing suction is the appropriate first intervention for a preterm baby that is apneic with fluid in the airway. In this situation, the presence of fluid can obstruct the airway, making it critical to remove any secretions or fluid that may be causing the apnea. Suctioning helps clear the airway, allowing for better oxygenation and ventilation.

After suctioning, if the baby remains apneic or shows signs of respiratory distress, additional interventions such as providing ventilations or oxygen therapy can be considered. Chest compressions are not the immediate response for an apneic infant unless there is a lack of pulse or significant cardiovascular compromise. Thus, suctioning is a vital and immediate response to ensure the airway is clear for effective breathing to resume.