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Gulati R, Sayegh L, McCurley C, Eyal F, Zayek M. Back vs. chest ECG electrode placement in neonatal resuscitation: A pilot randomized controlled trial. Resuscitation 2023; 192:109961. [PMID: 37678627 DOI: 10.1016/j.resuscitation.2023.109961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND The recent Neonatal Resuscitation Program advises the early utilization of an electrocardiogram (ECG) for non-vigorous newborns in the delivery room. However, placing ECG electrodes on the chest may delay obtaining a reliable heart rate (HR) and could interfere with chest compressions. Our previous study showed that preset ECG electrodes, attached to the back of the newborn, are quicker than a pulse oximeter (POX) for detecting HR. AIM To compare time to detect a reliable HR using back-placed ECG electrodes versus standard front placement. METHODS Infants were randomly assigned to back (n = 85) or chest (n = 89) electrode placement. Time measurement began upon placing infants on a Panda warmer ResusView. Failure was defined as no HR detected within 5 minutes. Intention-to-treat analysis compared HR signal acquisition time between groups. RESULTS Both groups showed similar proportions of detectable HR within the first minute. Median (IQR) time to obtain HR was 26 (13,38) seconds for the chest group and 21 (12,54) seconds for the back group (p = 0.91). A large number of vigorous infants were included. In the chest group, these vigorous infants had shorter HR acquisition times than non-vigorous infants (Mean ± SD of 34 ± 48 seconds vs. 50 ± 44 seconds respectively; p = 0.049). Failure rates and time to acquire a HR for infants who were non-vigorous and required advanced resuscitation were similar between the back and chest groups (p = 0.51). CONCLUSION Preset back ECG electrodes have shown encouraging results in neonates requiring advanced resuscitation. Further studies are needed to enhance guidance during neonatal resuscitation.
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Affiliation(s)
- Rashmi Gulati
- University of South Alabama Children's and Women's Hospital, 1700 Center Street, Mobile, AL 36604, USA.
| | - Lameace Sayegh
- University of South Alabama College of Medicine, 1700 Center Street, Mobile, AL 36604, USA
| | - Cathy McCurley
- University of South Alabama Children's and Women's Hospital, 1700 Center Street, Mobile, AL 36604, USA
| | - Fabien Eyal
- University of South Alabama Children's and Women's Hospital, 1700 Center Street, Mobile, AL 36604, USA
| | - Michael Zayek
- University of South Alabama Children's and Women's Hospital, 1700 Center Street, Mobile, AL 36604, USA
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2
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Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth. J Perinatol 2022:10.1038/s41372-022-01593-1. [PMID: 36587054 DOI: 10.1038/s41372-022-01593-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping. STUDY DESIGN Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth. RESULTS 198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01-2.26). CONCLUSION Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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Henry C, Shipley L, Morgan S, Crowe JA, Carpenter J, Hayes-Gill B, Sharkey D. Feasibility of a Novel ECG Electrode Placement Method in Newborn Infants. Neonatology 2022; 119:264-267. [PMID: 35130540 PMCID: PMC9153365 DOI: 10.1159/000521530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/07/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND International newborn resuscitation guidelines recommend electrocardiogram (ECG) heart rate (HR) monitoring at birth. We evaluated the application time of pre-set ECG electrodes fixed to a polyethene patch allowing adhesive-free attachment to the wet skin of the newborn chest. OBJECTIVES Using a three-electrode pre-set ECG patch configuration, application success was calculated using video analysis and measured at three time points, the time to (1) apply electrodes; (2) detect recognizable QRS complexes after application; and (3) display a HR after application. METHOD A prospective observational study in two UK tertiary maternity units was undertaken with 71 newborns including 23 who required resuscitation. RESULTS The median (IQR) time for ECG patch application was 8 (6-10) seconds, detection of recognizable QRS complexes 8 (2-12) seconds, and time to output HR was 23 (15-37) seconds. CONCLUSION Pre-set ECG chest electrodes allow rapid HR information at birth without electrode detachment or compromising skin integrity.
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Affiliation(s)
- Caroline Henry
- Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Lara Shipley
- Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Stephen Morgan
- Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - John A. Crowe
- Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | | | - Barrie Hayes-Gill
- Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Don Sharkey
- Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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4
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van Leuteren RW, Kho E, de Waal CG, Te Pas AB, Salverda HH, de Jongh FH, van Kaam AH, Hutten GJ. Cardiorespiratory monitoring in the delivery room using transcutaneous electromyography. Arch Dis Child Fetal Neonatal Ed 2021; 106:352-356. [PMID: 33214154 DOI: 10.1136/archdischild-2020-319535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To assess feasibility of transcutaneous electromyography of the diaphragm (dEMG) as a monitoring tool for vital signs and diaphragm activity in the delivery room (DR). DESIGN Prospective observational study. SETTING Delivery room. PATIENTS Newborn infants requiring respiratory stabilisation after birth. INTERVENTIONS In addition to pulse oximetry (PO) and ECG, dEMG was measured with skin electrodes for 30 min after birth. OUTCOME MEASURES We assessed signal quality of dEMG and ECG recording, agreement between heart rate (HR) measured by dEMG and ECG or PO, time between sensor application and first HR read-out and agreement between respiratory rate (RR) measured with dEMG and ECG, compared with airway flow. Furthermore, we analysed peak, tonic and amplitude diaphragmatic activity from the dEMG-based respiratory waveform. RESULTS Thirty-three infants (gestational age: 31.7±2.8 weeks, birth weight: 1525±661 g) were included.18%±14% and 22%±21% of dEMG and ECG data showed poor quality, respectively. Monitoring HR with dEMG was fast (median 10 (IQR 10-11) s) and accurate (intraclass correlation coefficient (ICC) 0.92 and 0.82 compared with ECG and PO, respectively). RR monitoring with dEMG showed moderate (ICC 0.49) and ECG low (ICC 0.25) agreement with airway flow. Diaphragm activity started high with a decreasing trend in the first 15 min and subsequent stabilisation. CONCLUSION Monitoring vital signs with dEMG in the DR is feasible and fast. Diaphragm activity can be detected and described with dEMG, making dEMG promising for future DR studies.
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Affiliation(s)
- Ruud W van Leuteren
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands .,Amsterdam Reproduction & Development Research Institute, Amsterdam, North-Holland, Netherlands
| | - Eline Kho
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands.,Technical Medicine, University of Twente, Enschede, Overijssel, Netherlands
| | - Cornelia G de Waal
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands
| | - Arjan B Te Pas
- Department of Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Hylke H Salverda
- Department of Neonatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Frans H de Jongh
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands.,Faculty of Science and Technology, University of Twente, Enschede, Overijssel, Netherlands
| | - Anton H van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands.,Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, North-Holland, Netherlands
| | - Gerard J Hutten
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, North-Holland, Netherlands.,Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, North-Holland, Netherlands
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5
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Heo JS, Kim SY, Park HW, Choi YS, Park CW, Cho GJ, Oh AY, Jang EK, Kim HS, Kim ARE, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 8. Neonatal resuscitation. Clin Exp Emerg Med 2021; 8:S96-S115. [PMID: 34034452 PMCID: PMC8171175 DOI: 10.15441/ceem.21.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/05/2021] [Indexed: 01/02/2023] Open
Affiliation(s)
- Ju Sun Heo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Su Yeong Kim
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hye Won Park
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
| | - Yong-Sung Choi
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chan-Wook Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Ah Young Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Kyung Jang
- Office of Patient Safety, Yonsei University Severance Hospital, Seoul, Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ai-Rhan Ellen Kim
- Department of Pediatrics, Ulsan University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Pike H, Eilevstjønn J, Bjorland P, Linde J, Ersdal H, Rettedal S. Heart rate detection properties of dry-electrode ECG compared to conventional 3-lead gel-electrode ECG in newborns. BMC Res Notes 2021; 14:166. [PMID: 33933159 PMCID: PMC8088562 DOI: 10.1186/s13104-021-05576-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/20/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To compare the accuracy of heart rate detection properties of a novel, wireless, dry-electrode electrocardiogram (ECG) device, NeoBeat®, to that of a conventional 3-lead gel-electrode ECG monitor (PropaqM®) in newborns. Results The study population had a mean gestational age of 39 weeks and 2 days (1.5 weeks) and birth weight 3528 g (668 g). There were 950 heart rate notations from each device, but heart rate was absent from the reference monitor in 14 of these data points, leaving 936 data pairs to compare. The mean (SD) difference when comparing NeoBeat to the reference monitor was -0.25 (9.91) beats per minute (bpm) (p = 0.44). There was a deviation of more than 10 bpm in 7.4% of the data pairs, which primarily (78%) was attributed to ECG signal disturbance, and secondly (22%) due to algorithm differences between the devices. Excluding these outliers, the correlation was equally consistent (r2 = 0.96) in the full range of heart rate captured measurements with a mean difference of − 0.16 (3.09) bpm. The mean difference was less than 1 bpm regardless of whether outliers were included or not. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05576-x.
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Affiliation(s)
- Hanne Pike
- Department of Paediatrics, Stavanger University Hospital, Post Box 8100, 4068, Stavanger, Norway
| | | | - Peder Bjorland
- Department of Paediatrics, Stavanger University Hospital, Post Box 8100, 4068, Stavanger, Norway
| | - Jørgen Linde
- Department of Paediatrics, Stavanger University Hospital, Post Box 8100, 4068, Stavanger, Norway
| | - Hege Ersdal
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Critical Care and Anaesthesiology Research Group, Stavanger University Hospital, Stavanger, Norway
| | - Siren Rettedal
- Department of Paediatrics, Stavanger University Hospital, Post Box 8100, 4068, Stavanger, Norway.
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7
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Wyckoff MH, Weiner CGM. 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Pediatrics 2021; 147:peds.2020-038505C. [PMID: 33087553 DOI: 10.1542/peds.2020-038505c] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for neonatal life support includes evidence from 7 systematic reviews, 3 scoping reviews, and 12 evidence updates. The Neonatal Life Support Task Force generally determined by consensus the type of evidence evaluation to perform; the topics for the evidence updates followed consultation with International Liaison Committee on Resuscitation member resuscitation councils. The 2020 CoSTRs for neonatal life support are published either as new statements or, if appropriate, reiterations of existing statements when the task force found they remained valid.Evidence review topics of particular interest include the use of suction in the presence of both clear and meconium-stained amniotic fluid, sustained inflations for initiation of positive-pressure ventilation, initial oxygen concentrations for initiation of resuscitation in both preterm and term infants, use of epinephrine (adrenaline) when ventilation and compressions fail to stabilize the newborn infant, appropriate routes of drug delivery during resuscitation, and consideration of when it is appropriate to redirect resuscitation efforts after significant efforts have failed.All sections of the Neonatal Resuscitation Algorithm are addressed, from preparation through to postresuscitation care. This document now forms the basis for ongoing evidence evaluation and reevaluation, which will be triggered as further evidence is published.Over 140 million babies are born annually worldwide (https://ourworldindata.org/grapher/births-and-deaths-projected-to-2100). If up to 5% receive positive-pressure ventilation, this evidence evaluation is relevant to more than 7 million newborn infants every year. However, in terms of early care of the newborn infant, some of the topics addressed are relevant to every single baby born.
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Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2020; 156:A156-A187. [DOI: 10.1016/j.resuscitation.2020.09.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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9
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Wyckoff MH, Wyllie J, Aziz K, de Almeida MF, Fabres J, Fawke J, Guinsburg R, Hosono S, Isayama T, Kapadia VS, Kim HS, Liley HG, McKinlay CJD, Mildenhall L, Perlman JM, Rabi Y, Roehr CC, Schmölzer GM, Szyld E, Trevisanuto D, Velaphi S, Weiner GM. Neonatal Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2020; 142:S185-S221. [PMID: 33084392 DOI: 10.1161/cir.0000000000000895] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for neonatal life support includes evidence from 7 systematic reviews, 3 scoping reviews, and 12 evidence updates. The Neonatal Life Support Task Force generally determined by consensus the type of evidence evaluation to perform; the topics for the evidence updates followed consultation with International Liaison Committee on Resuscitation member resuscitation councils. The 2020 CoSTRs for neonatal life support are published either as new statements or, if appropriate, reiterations of existing statements when the task force found they remained valid. Evidence review topics of particular interest include the use of suction in the presence of both clear and meconium-stained amniotic fluid, sustained inflations for initiation of positive-pressure ventilation, initial oxygen concentrations for initiation of resuscitation in both preterm and term infants, use of epinephrine (adrenaline) when ventilation and compressions fail to stabilize the newborn infant, appropriate routes of drug delivery during resuscitation, and consideration of when it is appropriate to redirect resuscitation efforts after significant efforts have failed. All sections of the Neonatal Resuscitation Algorithm are addressed, from preparation through to postresuscitation care. This document now forms the basis for ongoing evidence evaluation and reevaluation, which will be triggered as further evidence is published. Over 140 million babies are born annually worldwide (https://ourworldindata.org/grapher/births-and-deaths-projected-to-2100). If up to 5% receive positive-pressure ventilation, this evidence evaluation is relevant to more than 7 million newborn infants every year. However, in terms of early care of the newborn infant, some of the topics addressed are relevant to every single baby born.
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Aziz K, Lee HC, Escobedo MB, Hoover AV, Kamath-Rayne BD, Kapadia VS, Magid DJ, Niermeyer S, Schmölzer GM, Szyld E, Weiner GM, Wyckoff MH, Yamada NK, Zaichkin J. Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S524-S550. [DOI: 10.1161/cir.0000000000000902] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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11
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Heart Rate Assessment during Neonatal Resuscitation. Healthcare (Basel) 2020; 8:healthcare8010043. [PMID: 32102255 PMCID: PMC7151423 DOI: 10.3390/healthcare8010043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/07/2020] [Accepted: 02/19/2020] [Indexed: 12/02/2022] Open
Abstract
Approximately 10% of newborn infants require some form of respiratory support to successfully complete the fetal-to-neonatal transition. Heart rate (HR) determination is essential at birth to assess a newborn’s wellbeing. Not only is it the most sensitive indicator to guide interventions during neonatal resuscitation, it is also valuable for assessing the infant’s clinical status. As such, HR assessment is a key step at birth and throughout resuscitation, according to recommendations by the Neonatal Resuscitation Program algorithm. It is essential that HR is accurate, reliable, and fast to ensure interventions are delivered without delay and not prolonged. Ineffective HR assessment significantly increases the risk of hypoxic injury and infant mortality. The aims of this review are to summarize current practice, recommended techniques, novel technologies, and considerations for HR assessment during neonatal resuscitation at birth.
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12
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Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes. Resuscitation 2019; 143:10-16. [DOI: 10.1016/j.resuscitation.2019.07.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/14/2019] [Accepted: 07/29/2019] [Indexed: 11/23/2022]
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13
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Lemoine S, Chabernaud JL, Briche F, Renard A, Jost D, Tourtier JP. Re: Gulati et al.'s article "Presetting ECG electrodes for earlier heart rate detection in the delivery room.": Prehospital use of ECG electrodes by nonmedical emergency professionals: An additional source of help during unexpected out-of-hospital births. Resuscitation 2019; 132:e1. [PMID: 30316519 DOI: 10.1016/j.resuscitation.2018.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Sabine Lemoine
- Paris Fire Brigade Medical Emergency Department, Paris, France.
| | - Jean-Louis Chabernaud
- Division of Pediatrics and Neonatal Critical Care, FAME Department, South Paris University Hospitals, "A. Beclere" Medical Center - APHP, Paris, France
| | | | - Aurelien Renard
- Military Teaching Hospital, HIA Sainte Anne, Emergency Department, Toulon, France
| | - Daniel Jost
- Paris Fire Brigade Medical Emergency Department, Paris, France; Sudden Death Expertise Center (SDEC), INSERM U970, Paris, France
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Who's counting? Assessing the effects of a simulation-based training intervention on the accuracy of neonatal heart rate auscultation. J Perinatol 2019; 39:634-639. [PMID: 30770884 DOI: 10.1038/s41372-019-0339-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/14/2018] [Accepted: 01/25/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine if simulation-based medical education could improve pediatric residents' ability to accurately assess neonatal heart rate via auscultation. STUDY DESIGN Primary outcomes included heart rate accuracy and Neonatal Resuscitation Program (NRP) group accuracy, defined as whether a heart rate estimation fell in the appropriate NRP algorithm group. Pediatric residents completed a pre-assessment and then participated in a simulation training intervention on high-fidelity manikins. Residents completed a post-assessment 1 month later. RESULTS Heart rate estimates from 21 pediatric residents showed improved overall heart rate accuracy and NRP group accuracy from 53.6 to 78.7% (p < 0.0001) and 68.3 to 80% (p = 0.0002), respectively. Residents were more likely to overestimate low heart rates and underestimate high heart rates. CONCLUSION Heart rate simulation-based training significantly improved residents' ability to assess heart rate on high-fidelity neonatal manikins. Providers participating in NRP may benefit by receiving heart rate skills assessment-focused training during an NRP provider course.
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Rashmi G, Michael Z, Fabien E. Response to Letter to Editor: Gulati et al.'s article "Presetting ECG electrodes for earlier heart rate detection in the delivery room.": Prehospital use of ECG electrodes by nonmedical emergency professionals: An additional source of help during unexpected out-of-hospital births. Resuscitation 2019; 137:242-243. [PMID: 30763597 DOI: 10.1016/j.resuscitation.2018.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Gulati Rashmi
- University of South Alabama, Mobile, AL, United States.
| | - Zayek Michael
- University of South Alabama, Mobile, AL, United States
| | - Eyal Fabien
- University of South Alabama, Mobile, AL, United States
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