Characterizing prehospital response to neonatal resuscitation
Objective: To evaluate performance of initial steps of newborn resuscitation according to the American Heart Association and American Academy of Pediatrics’ Neonatal Resuscitation Program (NRP) guidelines in the prehospital setting. Study Design: Observational study of 265 paramedics and Emergency M...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520421000114 |
| _version_ | 1819081841371512832 |
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| author | Trang Kieu Huynh Amanda Schoonover Tabria Harrod Nathan Bahr Jeanne-Marie Guise |
| author_facet | Trang Kieu Huynh Amanda Schoonover Tabria Harrod Nathan Bahr Jeanne-Marie Guise |
| author_sort | Trang Kieu Huynh |
| collection | DOAJ |
| description | Objective: To evaluate performance of initial steps of newborn resuscitation according to the American Heart Association and American Academy of Pediatrics’ Neonatal Resuscitation Program (NRP) guidelines in the prehospital setting. Study Design: Observational study of 265 paramedics and Emergency Medical Technicians (EMTs) from 45 EMS teams recruited from public fire and private transport agencies in a major metropolitan area. Participants completed a baseline questionnaire assessing demographics, experience, and comfort in caring for children. Simulations were conducted April 2015 to March 2016. Technical performance was evaluated by blinded video review. NRP actions were assessed using a structured performance tool. Results: Two hundred sixty-five EMS providers responded to survey questions and participated in simulations. In total, 16% reported feeling very or extremely comfortable caring for children <30 days of age (vs. 71% for children aged 12–18 years). Among 45 EMS teams participating in simulations, 22% (n = 10) dried, 18% (n = 8) stimulated, and 2% (n = 1) warmed within 30 s from arrival and 11% (n = 5) provided BMV within 60 s from arrival, as recommended by NRP. All teams provided BMV. Eighty-eight percent bagged below NRP rate recommendations and 96% bagged with tidal volume exceeding guidelines. Looking over the entire 10-min simulation for ever performing measures, 73% started to dry the baby within a median of 51 (range 0−539) seconds from arrival, 38% started to stimulate the baby within a median of 34 s (range 0−181), and 44% started to warm the baby within a median 291 s (range 27−575 s). Conclusions: These data from field simulations suggest NRP steps recommended for the first minute after birth are seldom performed in a timely manner and suggests opportunities for improvement. |
| first_indexed | 2024-12-21T20:07:11Z |
| format | Article |
| id | doaj.art-fac0b80cfd7644d0bcfda850b76e7f60 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-12-21T20:07:11Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-fac0b80cfd7644d0bcfda850b76e7f602022-12-21T18:51:50ZengElsevierResuscitation Plus2666-52042021-03-015100086Characterizing prehospital response to neonatal resuscitationTrang Kieu Huynh0Amanda Schoonover1Tabria Harrod2Nathan Bahr3Jeanne-Marie Guise4Department of Pediatrics, Oregon Health and Science University, United States; Corresponding author at: Department of Pediatrics, Division of Neonatology, Oregon Health and Science University, 707 SW Gaines Street, CDRCP, Portland, OR 97239, United States.Department of Obstetrics and Gynecology, Oregon Health and Science University, United StatesDepartment of Obstetrics and Gynecology, Oregon Health and Science University, United StatesDepartment of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, United StatesDepartment of Obstetrics and Gynecology, Oregon Health and Science University, United StatesObjective: To evaluate performance of initial steps of newborn resuscitation according to the American Heart Association and American Academy of Pediatrics’ Neonatal Resuscitation Program (NRP) guidelines in the prehospital setting. Study Design: Observational study of 265 paramedics and Emergency Medical Technicians (EMTs) from 45 EMS teams recruited from public fire and private transport agencies in a major metropolitan area. Participants completed a baseline questionnaire assessing demographics, experience, and comfort in caring for children. Simulations were conducted April 2015 to March 2016. Technical performance was evaluated by blinded video review. NRP actions were assessed using a structured performance tool. Results: Two hundred sixty-five EMS providers responded to survey questions and participated in simulations. In total, 16% reported feeling very or extremely comfortable caring for children <30 days of age (vs. 71% for children aged 12–18 years). Among 45 EMS teams participating in simulations, 22% (n = 10) dried, 18% (n = 8) stimulated, and 2% (n = 1) warmed within 30 s from arrival and 11% (n = 5) provided BMV within 60 s from arrival, as recommended by NRP. All teams provided BMV. Eighty-eight percent bagged below NRP rate recommendations and 96% bagged with tidal volume exceeding guidelines. Looking over the entire 10-min simulation for ever performing measures, 73% started to dry the baby within a median of 51 (range 0−539) seconds from arrival, 38% started to stimulate the baby within a median of 34 s (range 0−181), and 44% started to warm the baby within a median 291 s (range 27−575 s). Conclusions: These data from field simulations suggest NRP steps recommended for the first minute after birth are seldom performed in a timely manner and suggests opportunities for improvement.http://www.sciencedirect.com/science/article/pii/S2666520421000114Neonatal resuscitationEmergency medical servicePrehospitalNewborn care |
| spellingShingle | Trang Kieu Huynh Amanda Schoonover Tabria Harrod Nathan Bahr Jeanne-Marie Guise Characterizing prehospital response to neonatal resuscitation Resuscitation Plus Neonatal resuscitation Emergency medical service Prehospital Newborn care |
| title | Characterizing prehospital response to neonatal resuscitation |
| title_full | Characterizing prehospital response to neonatal resuscitation |
| title_fullStr | Characterizing prehospital response to neonatal resuscitation |
| title_full_unstemmed | Characterizing prehospital response to neonatal resuscitation |
| title_short | Characterizing prehospital response to neonatal resuscitation |
| title_sort | characterizing prehospital response to neonatal resuscitation |
| topic | Neonatal resuscitation Emergency medical service Prehospital Newborn care |
| url | http://www.sciencedirect.com/science/article/pii/S2666520421000114 |
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