Timing and documentation of key events in neonatal resuscitation

Heathcote, Adam Charles; Jones, Jacqueline; Clarke, Paul

doi:10.1007/s00431-018-3160-8

Cited by 14 publications

(15 citation statements)

References 9 publications

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“…In simulation studies, a UVC can be inserted in 105 s (53). However, in real-life cases, this takes longer (51,54). No RCTs have compared different routes of administration; however, simulation can be used to compare different methods of vascular access insertion.…”

Section: Adrenaline/accessmentioning

confidence: 99%

Simulation in Neonatal Resuscitation

Garvey

Dempsey

2020

Front. Pediatr.

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Approximately 1 in 10 newborns will require basic resuscitation interventions at birth. Some infants progress to require more advanced measures including the provision of positive pressure ventilation, chest compressions, intubation and administration of volume/cardiac medications. Although advanced resuscitation is infrequent, it is crucial that personnel adequately trained in these techniques are available to provide such resuscitative measures. In 2000, Louis Halmalek et al. called for a "New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment." This was one of the first articles to highlight simulation as a method of teaching newborn resuscitation. The last decades have seen an exponential growth in the area of simulation in newborn care, in particular in newborn resuscitation and stabilization. Simulation is best defined as an instructional strategy "used to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner." Simulation training has now become an important point of how we structure training and deliver improved healthcare to patients. Some of the key aspects of simulation training include feedback, deliberate practice, outcome measurement, retention of skills and curriculum integration. The term "Train to win" is often used in sporting parlance to define how great teams succeed. The major difference between sports teams is that generally their game day comes once a week, whereas in newborn resuscitation every day is potentially "game day." In this review we aim to summarize the current evidence on the use of simulation based education and training in neonatal resuscitation, with particular emphasis on the evidence supporting its effectiveness. We will also highlight recent advances in the development of simulation based medical education in the context of newborn resuscitation to ensure we "train to win."

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Section: Adrenaline/accessmentioning

confidence: 99%

Simulation in Neonatal Resuscitation

Garvey

Dempsey

2020

Front. Pediatr.

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“…Consecutive children in cardiac arrest given a high dose of epinephrine (0.2 mg/kg) after failure to respond to 2 doses of 0.01 mg/kg. A high dose of epinephrine (0.2 mg/kg per dose) was given via umbilical arterial catheter in 3 preterm infants (28,29, and 34 wk' gestation) on day 2-3 after birth.…”

Section: Goetting and Oaradis 22 1989mentioning

confidence: 99%

The Route, Dose, and Interval of Epinephrine for Neonatal Resuscitation: A Systematic Review

et al. 2020

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CONTEXT: Current International Liaison Committee on Resuscitation recommendations on epinephrine administration during neonatal resuscitation were derived in 2010 from indirect evidence in animal or pediatric studies.OBJECTIVE: Systematic review of human infant and relevant animal studies comparing other doses, routes, and intervals of epinephrine administration in neonatal resuscitation with (currently recommended) administration of 0.01 to 0.03 mg/kg doses given intravenously (IV) every 3 to 5 minutes.DATA SOURCES: Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and trial registry databases.STUDY SELECTION: Predefined criteria were used for selection.DATA EXTRACTION: Risk of bias was assessed by using published tools appropriate for the study type. Certainty of evidence was assessed by using Grading of Recommendations Assessment, Development and Evaluation.RESULTS: Only 2 of 4 eligible cohort studies among 593 unique retrieved records yielded data allowing comparisons. There were no differences between IV and endotracheal epinephrine for the primary outcome of death at hospital discharge (risk ratio = 1.03 [95% confidence interval 0.62 to 1.71]) or for failure to achieve return of spontaneous circulation, time to return of spontaneous circulation (1 study; 50 infants), or proportion receiving additional epinephrine (2 studies; 97 infants). There were no differences in outcomes between 2 endotracheal doses (1 study). No human infant studies were found in which authors addressed IV dose or dosing interval. LIMITATIONS:The search yielded sparse human evidence of very low certainty (downgraded for serious risk of bias and imprecision).CONCLUSIONS: Administration of epinephrine by endotracheal versus IV routes resulted in similar survival and other outcomes. However, in animal studies, researchers continue to suggest benefit of IV administration using currently recommended doses.

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“…The neonatal database BadgerNet (Clevermed, 2017), which is used throughout the UK and further afield, is a useful vehicle for research and benchmarking; for example, Heathcote et al (2018) used this database to examine the timing and documentation of key events in neonatal resuscitation.…”

Section: Best Chance Of Survivalmentioning

confidence: 99%