Accuracy of real-time delivery room resuscitation documentation

Fishman, Claire E.; Weinberg, Danielle; Murray, Ashley M.; Foglia, Elizabeth E.

doi:10.1136/archdischild-2018-315723

Cited by 10 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, we do not have data on duration of intubation attempts, which may significantly impact first-attempt success rates, adverse TIAEs, and oxygen desaturation. Future studies using video recording carts will facilitate such data collection [41, 42].…”

Section: Discussionmentioning

confidence: 99%

Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS)

Johnston¹,

Sawyer²,

Ades³

et al. 2021

Neonatology

Self Cite

View full text Add to dashboard Cite

Introduction: Neonatal tracheal intubation (TI) outcomes have been assessed by role, but training level may impact TI success and safety. Effect of physician training level (PTL) on the first-attempt success, adverse TI-associated events (TIAEs), and oxygen desaturation was assessed. Methods: Prospective cohort study in 11 international NEAR4NEOS sites between October 2014 and December 2017. Primary TIs performed by pediatric/neonatal physicians were included. Univariable analysis evaluated association between PTL, patient/practice characteristics, and outcomes. Multivariable analysis with generalized estimating equation assessed for independent association between PTL and outcomes (first-attempt success, TIAEs, and oxygen desaturation ≥20%; attending as reference). Results: Of 2,608 primary TIs, 1,298 were first attempted by pediatric/neonatal physicians. PTL was associated with patient age, weight, comorbidities, TI indication, difficult airway history, premedication, and device. First-attempt success rate differed across PTL (resident 23%, fellow 53%, and attending 60%; p < 0.001). There was no statistically significant difference in TIAEs (resident 22%, fellow 20%, and attending 25%; p = 0.34). Desaturation occurred more frequently with residents (60%), compared to fellows and attendings (46 and 53%; p < 0.001). In multivariable analysis, adjusted odds ratio of the first-attempt success was 0.18 (95% CI: 0.11–0.30) for residents and 0.80 (95% CI: 0.51–1.24) for fellows. PTL was not independently associated with adjusted odds of TIAEs or severe oxygen desaturation. Conclusion: Higher PTL was associated with increased first-attempt success but not TIAE/oxygen desaturation. Identifying strategies to decrease adverse events during neonatal TI remains critical.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS)

Johnston¹,

Sawyer²,

Ades³

et al. 2021

Neonatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The strengths of the present study include (1) data collection from review of video recordings allowing detailed monitoring of observed parameters, signal quality and hence enhanced reliability of data20 21; (2) the assessment of SpO 2 and heart rate in a low-resource setting where PPV is performed in room air without the SpO 2 monitoring.…”

Section: Discussionmentioning

confidence: 99%

Oxygen saturation after birth in resuscitated neonates in Uganda: a video-based observational study

Larsson

Höök

Mpamize

et al. 2022

bmjpo

View full text Add to dashboard Cite

BackgroundMonitoring of peripheral capillary oxygen saturation (SpO2) during neonatal resuscitation is standard of care in high-resource settings, but seldom performed in low-resource settings. We aimed to measure SpO2 and heart rate during the first 10 min of life in neonates receiving positive pressure ventilation (PPV) according to the Helping Babies Breathe (HBB) protocol and compare results with SpO2 and heart rate targets set by the American Heart Association (AHA).MethodsA cross-sectional study was conducted at Mulago National Referral Hospital, Kampala, Uganda, as a substudy of the NeoSupra Trial. SpO2 and heart rate were measured on apnoeic neonates (≥34 weeks) who received PPV according to HBB (room air). Those who remained distressed after PPV received supplemental oxygen (O2). All resuscitations were video recorded and data were extracted by video review at 1 min intervals until 10 min post partum. Data were analysed for all observations and separately for only observations before and during PPV.Results49 neonates were analysed. Median SpO2 at 5 min (n=39) was 67% (49–88) with 59% of the observations below AHA target of 80%. At 10 min median SpO2 (n=44) was 93% (80–97) and 32% were below AHA target of 85%. When only observations before and during PPV were analysed, median SpO2 at 5 min (n=18) was 52% (34–66) and 83% were below AHA target. At 10 min (n=15), median SpO2 was 72% (57–89) and 67% were below AHA target. Median heart rates were above AHA target of 100 beats/min at all time intervals.ConclusionsA high proportion of neonates resuscitated with PPV after birth failed to reach the AHA SpO2 target in this small sample, implying an increased risk of hypoxic-ischaemic encephalopathy. Further studies in low-resource settings are needed to evaluate baseline data and the need for supplemental O2 and optimal SpO2 during PPV.Trial registration numberThis is a substudy to the trial ‘Neonatal Resuscitation with Supraglottic Airway Trial (NeoSupra)’; ClinicalTrials.gov Registry (NCT03133572).

show abstract

“…VR-based studies have shown that traditional paper documentation was less accurate than video for early vital signs and at the timing of procedures. 57 VR improves adherence to best practice guidelines and has led to changes in international resuscitation guidelines. These effects can be seen in simulation as well as real-life scenarios, both in high-and low-resource settings.…”

Section: Discussionmentioning

confidence: 99%

“…VR is more accurate in documenting vital sign assessments than paper-based documentation even when done in real-time. 57,58 In addition, it offers the opportunity to objectively analyse the impact of interventions on physiological measures such as heart rate, skin colour or breathing effort. 31,37,39,55,58 Thus, VR is an invaluable tool for improving knowledge on neonatal transition and the effect of interventions during DR care.…”

Section: Vr For Research Purposesmentioning

confidence: 99%

Video recording in the delivery room: current status, implications and implementation

et al. 2021

View full text Add to dashboard Cite

Many factors determine the performance and success of delivery room management of newborn babies. Improving the quality of care in this challenging surrounding has an important impact on patient safety and on perinatal morbidity and mortality. Video recording (VR) offers the advantage to record and store work as done rather than work as recalled. It provides information about adherence to algorithms and guidelines, and technical, cognitive and behavioural skills. VR is feasible for education and training, improves team performance and results of research led to changes of international guidelines. However, studies thus far have not provided data regarding whether delivery room video recording affects long-term team performance or clinical outcomes. Privacy is a concern because data can be stored and individuals can be identified. We describe the current state of clinical practice in highand low-resource settings, discuss ethical and medical-legal issues and give recommendations for implementation with the aim of improving the quality of care and outcome of vulnerable babies.

show abstract

Accuracy of real-time delivery room resuscitation documentation

Cited by 10 publications

References 5 publications

Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS)

Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS)

Oxygen saturation after birth in resuscitated neonates in Uganda: a video-based observational study

Video recording in the delivery room: current status, implications and implementation

Contact Info

Product

Resources

About