A Survey of Academic Neonatologists on Neonatal Electrical Cardioversion and Defibrillation

Abstract

Objective: Assess neonatologists’ experience and comfort with neonatal electrical cardioversion or defibrillation (EC-D). Study Design: Electronic surveys were distributed to academic neonatologists affiliated with 12 Midwest academic hospitals. Neonatologists were asked about their residency training; years since completing residency; current certification/ competency training in BLS, PALS, ACLS and NRP; experiences with EC-D; availability of a pediatric cardiologist and their comfort levels with such procedures. Standard statistical tests evaluated comfort with EC-D. Results: Seventy-two out of 180 neonatologists responded to the survey (response rate=40%). 98.6% (71), 54.2% (39) and 37.5% (27) maintained current NRP, BLS and PALS training respectively. 73.6% (n=53) reported having performed neonatal EC-D. Of those, 50.9% (n=27) indicated feeling slightly to very uncomfortable performing EC-D. We report a lack of BLS certification being associated with lack of comfort (OR: 0.269 - 95% CI [0.071, 0.936]), and a positive association between a pediatric cardiologist being present and being uncomfortable (OR: 3.722 – 95% CI [1.069,14.059]). Those reporting greater volume and more recent experience with EC-D report more comfort. Conclusion: Of neonatologists that performed EC-D, half reported being uncomfortable. BLS certification and experience are positively associated with comfort in performing EC-D. Simulations to increase training in EC-D should be offered regularly to academic neonatologists.