Characterizing prehospital response to neonatal resuscitation

Huynh, Trang; Schoonover, Amanda; Harrod, Tabria; Bahr, Nathan; Guise, Jeanne‐Marie

doi:10.1016/j.resplu.2021.100086

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…Previous studies have identified practice deviation from NRP guidelines by prehospital providers, especially with regard to drying, warming, stimulating, and suctioning the baby [ 20 ]. These practice deviations are not only frequent, but also have the potential for mild and even severe harm [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Athanasopoulou,

Cicero,

Sanseau

et al. 2024

Cureus

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Objectives: Few studies have described the current clinical practices, adherence to guidelines, and outcomes of newborn resuscitations attended by emergency medical services (EMS). SimBox, a novel, video-augmented simulation, was used to describe the adherence of prehospital providers to Neonatal Resuscitation Program guidelines, to measure satisfaction with the simulation intervention, and to describe the self-reported improvement in knowledge, skills, and attitudes after the simulation. Methods: A prospective observational cohort study of EMS providers was designed and conducted using SimBox, an open-access simulation platform, and facilitated by EMS educators. Clinical performance measures were collected using a five-item checklist. Simulation satisfaction measures were collected through net promoter scores. Learners’ demographics, and self-reported knowledge, skills, and attitudes were measured using a retrospective survey of 25 questions. Results: In total, 33 facilitator and 55 learner surveys were collected across Connecticut, Colorado, and Alaska between July 2021 and September 2022. At least one deviation from clinical guidelines occurred in 22/30 (73.3%) of the sessions, with 10/30 (33.3%) teams inappropriately performing chest compressions, 5/31 (16.1%) teams not warming, drying, stimulating, and suctioning the newborn, and 7/31 (22.6%) teams not performing positive pressure ventilation correctly. Lastly, 10/30 (33.3%) teams administered an incorrect dose of dextrose-containing fluids. Very high levels of satisfaction were reported with net promoter scores of 97 and 82 out of 100 for the facilitator and learner surveys, respectively. Finally, all 55/55 (100%) of the learners strongly or somewhat agreed that the simulation improved their knowledge, teamwork, communication, and psychomotor skills. Conclusions: In this cohort of prehospital providers, clinical management decisions during a newborn resuscitation simulation often deviated from the gold-standard, newborn resuscitation guidelines. Free, online, open-access simulation resources like SimBox can be used to identify and measure practice deviations from standardized resuscitation protocols in the prehospital setting.

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Section: Discussionmentioning

confidence: 99%

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Athanasopoulou,

Cicero,

Sanseau

et al. 2024

Cureus

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“…A study that evaluated the EMS personnel's comfort level in neonatal resuscitation and NRP compliance in out-of-hospital unplanned deliveries found that 66% of the 230 respondents either never had NRP training or completed NRP training more than two years ago. EMS personnel in this study were neither comfortable with basic skills in the initial stabilization of the infant nor had the newborn size-specific equipment for use [99]. Training EMS personnel for the low-frequency, high-risk scenario should potentially involve skills that have ease of training, high success rate, and low skill decay.…”

Section: Lm Use In Prehospital Settingsmentioning

confidence: 94%

Laryngeal Masks in Neonatal Resuscitation—A Narrative Review of Updates 2022

2022

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Positive pressure ventilation (PPV) is crucial to neonatal cardiopulmonary resuscitation because respiratory failure precedes cardiac failure in newborns affected by perinatal asphyxia. Prolonged ineffective PPV could lead to a need for advanced resuscitation such as intubation, chest compression, and epinephrine. Every 30 s delay in initiation of PPV increased the risk of death or morbidity by 16%. The most effective interface for providing PPV in the early phases of resuscitation is still unclear. Laryngeal masks (LMs) are supraglottic airway devices that provide less invasive and relatively stable airway access without the need for laryngoscopy which have been studied as an alternative to face masks and endotracheal tubes in the initial stages of neonatal resuscitation. A meta-analysis found that LM is a safe and more effective alternative to face mask ventilation in neonatal resuscitation. LM is recommended as an alternative secondary airway device for the resuscitation of infants > 34 weeks by the International Liaison Committee on Resuscitation. It is adopted by various national neonatal resuscitation guidelines across the globe. Recent good-quality randomized trials have enhanced our understanding of the utility of laryngeal masks in low-resource settings. Nevertheless, LM is underutilized due to its variable availability in delivery rooms, providers’ limited experience, insufficient training, preference for endotracheal tube, and lack of awareness.

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“…This is an extension of an earlier study, where we evaluated performance of the first critical steps of NRP: dry, warm, stimulate, and bag-valve mask ventilation. 22 This paper focuses on the effects of teamwork on compliance with NRP guidelines across the entire resuscitation. This study was funded by the US National Institutes of Child Health and Human Development (NICHD R01HD062478) and Agency for Healthcare Research and Quality (AHRQ F32HS025590), and it was approved by Oregon Health & Science University’s Institutional Review Board (IRB# 00006942).…”

Section: Methodsmentioning

confidence: 99%

“…A neonatologist independently reviewed videos of the teams and evaluated technical performance using a predetermined structured intake form. 22 The intake form captured information about NRP tasks such as, time performed, if they were done correctly, and attributes of performance. For example, we would track that a team incorrectly performed bag-valve mask ventilation (BVM) at 1:20 (mm:ss) using an adult-sized Ambu® bag, pushing full volume at a slow rate .…”

Section: Methodsmentioning

confidence: 99%