Time Perception during Neonatal Resuscitation

Trevisanuto, Daniele; Bernardo, Giuseppe De; Res, Giulia; Sordino, Desirée; Doglioni, Nicoletta; Weiner, Gary M.; Cavallin, Francesco

doi:10.1016/j.jpeds.2016.07.003

Cited by 26 publications

(30 citation statements)

References 15 publications

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“…However, based on previous studies, the 2015 guidelines recommend to start PPV within 60 s after birth, that fits with our participants’ performance [1]. Every effort, however, should be done by instructors to emphasize the importance of avoiding unnecessary delay in initiating ventilation [16]. The effectiveness of our course was similar to that found in a real-life neonatal resuscitation setting [17], but was lower to that reported in a previous study using the same assessment instrument, but in a different group of subjects [9].…”

Section: Discussionmentioning

confidence: 64%

Performances of low level hospital health caregivers after a neonatal resuscitation course

Bernardo¹,

Sordino²,

Cavallin³

et al. 2016

Ital J Pediatr

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BackgroundHigh fidelity simulation has been executed to allow the evaluation of technical and non-technical skills of health caregivers. Our objective was to assess technical and non-technical performances of low level hospitals health caregivers who attended a Neonatal Resuscitation course using high fidelity simulation in a standard-setting scenario.MethodsTwenty-three volunteers were asked to manage a simple scenario (infant with secondary apnea) after the course. Technical and non-technical skills were assessed by using previously published scores. Performances were assessed during the scenario and after 2 months by filmed video recordings.ResultsSixteen (69.5%) participants failed to pass the minimum required technical score. Staff experience and participation in previous courses were associated to higher score in technical and non-technical skills, while working in level I or II hospitals did not affect the scores. Previous experience in neonatal resuscitation requiring positive pressure ventilation was associated to better non-technical performance. Technical and non-technical scores were significantly correlated (r = 0.67, p = 0.0005). Delayed and direct evaluation of technical skills provided the same scores.ConclusionsA neonatal resuscitation course, performed by using a high fidelity simulation manikin, had a limited impact on technical and non-technical skills of participants working in low level hospitals. Training programs should be tailored to the participants’ professional background and to the more relevant sessions.

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Section: Discussionmentioning

confidence: 64%

Performances of low level hospital health caregivers after a neonatal resuscitation course

Bernardo¹,

Sordino²,

Cavallin³

et al. 2016

Ital J Pediatr

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“…This simulation study was performed at the SIMNOVA Center of the University of Piemonte Orientale in Novara (Italy). The scenario consisted of an asphyxiated term infant needing a complex resuscitation including positive pressure ventilation, endotracheal intubation, chest compressions and emergency medications (neonatal simulator manikin: Newborn HAL S3010; Gaumard Scientific, Miami, Florida), as described elsewhere 8. Briefly, HR, respiratory rate and breath sounds were controlled remotely and could be assessed by auscultation of the thorax and observation of chest movements.…”

Section: Methodsmentioning

confidence: 99%

“…Assessing the HR by auscultation can be limited due to imprecise auscultation and/or errors in mental computation,4 5 leading to inappropriate or delayed resuscitation 1. Previous studies evaluated a free-of-charge mobile application (NeoTapAdvancedSupport, NeoTapAS)6 to help HR assessment in a simulated scenario of neonatal resuscitation 7 8. NeoTapAS showed good accuracy in estimating HR and could be a useful tool in resource-constrained settings 8…”

Section: Introductionmentioning

confidence: 99%

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Impact of a mobile application for heart rate assessment in simulated neonatal resuscitation: a randomised controlled cross-over study

Cavallin

Binotti

Ingrassia

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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BackgroundClinical assessment of newborn heart rate (HR) at birth has been reported to be inaccurate. NeoTapAdvancedSupport (NeoTapAS) is a free-of-charge mobile application that showed good accuracy in HR estimation. This study aimed to evaluate the impact of NeoTapAS on timing of HR communication and resuscitation interventions.MethodsThis was a randomised controlled cross-over (AB/BA) study evaluating HR assessment using auscultation plus NeoTapAS compared with auscultation plus mental computation in a high-fidelity simulated newborn resuscitation scenario. Twenty teams each including three paediatric residents were randomly assigned to AB or BA arms. The primary outcome was the timing of the first HR communication. Secondary outcomes included the timing of the following four HR communications and the timing of resuscitation interventions (positive pressure ventilation, chest compressions, intubation and administration of first dose of epinephrine).ResultsNeoTapAS reduced the time to the first HR communication (mean difference −13 s, 95% CI −23 to −4; p=0.009), and the time of initiation of chest compressions (mean difference −68 s, 95% CI −116 to −18; p=0.01) and administration of epinephrine (mean difference −76 s, 95% CI −115 to −37; p=0.0004) compared with mental computation.ConclusionsIn a neonatal resuscitation simulated scenario, NeoTapAS reduced the time to the first HR communication and the time of initiation of chest compressions and administration of epinephrine compared with mental computation. This app can be especially useful in settings with limited availability of monitoring equipment, but further studies in clinical scenarios are warranted.Trial registration numberNCT03730025.

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“…While several cases reviewed had paper towels filed in the front of their case notes with obviously contemporaneous scribbled timings of events on them, in most cases it was unclear whether the timings had been recorded “live” during the resuscitation by an independent scribe, or whether they had been written retrospectively on reflection by the practitioner soon after the event. Resuscitating practitioners may underestimate the passage of time in neonatal resuscitation [11], which could lead to true timings being even later than documented. A future prospective study which aims to log the key resuscitation milestones contemporaneously and rigorously would be of interest, not least for comparison purposes with our retrospective data hereby presented.…”

Section: Discussionmentioning

confidence: 99%

Timing and documentation of key events in neonatal resuscitation

2018

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Only a minority of babies require extended resuscitation at birth. Resuscitations concerning babies who die or who survive with adverse outcomes are increasingly subject to medicolegal scrutiny. Our aim was to describe real-life timings of key resuscitation events observed in a historical series of newborns who required full resuscitation at birth. Twenty-seven babies born in our centre over a 10-year period had an Apgar score of 0 at 1 min and required full resuscitation. The median (95% confidence interval) postnatal age at achieving key events were commencing cardiac compressions, 2.0 (1.5–4.0) min; endotracheal intubation, 3.8 (2.0–6.0) min; umbilical venous catheterisation 9.0 (7.5–12.0) min; and administration of first adrenaline dose 10.0 (8.0–14.0) min.Conclusion: The wide range of timings presented from real-life cases may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training. What is Known: • Only a minority of babies require extended resuscitation at birth; these cases are often subject to medicolegal interrogation • Timings of key resuscitation events are poorly described and documentation of resuscitation events is often lacking yet is open to medicolegal scrutiny What is New: • We present a wide range of real-life timings of key resuscitation events during the era of routine newborn life support training • These timings may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training

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Time Perception during Neonatal Resuscitation

Cited by 26 publications

References 15 publications

Performances of low level hospital health caregivers after a neonatal resuscitation course

Performances of low level hospital health caregivers after a neonatal resuscitation course

Impact of a mobile application for heart rate assessment in simulated neonatal resuscitation: a randomised controlled cross-over study

Timing and documentation of key events in neonatal resuscitation

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