Comparison of methods of bag and mask ventilation for neonatal resuscitation

Background: Improving the performance of health workers on neonatal resuscitation will be critical to ensure that the babies are effectively ventilated. We conducted a study to evaluate whether a bag-and-mask ventilation with monitor is effective in improving neonatal resuscitation practice in a simulated setting. Methods: This is a cross-over design conducted in 6 public hospitals with 82 health workers of Nepal nested over a large scale stepped wedged quality improvement project. A one-day training on neonatal resuscitation was conducted. At the end of the training, participants were evaluated on the bag-and-mask ventilation performance in a manikinbased on the tidal volume, positive end expiratory pressure and air leakage from the maskin two sessions (monitor displayed versus hidden). The comparison of the neonatal resuscitation performance with and without monitor displayed is calculated. We also conducted assessment of confidence with or without monitor of the health workers. Results: Adequacy of ventilation using bag-and-mask was better when the health workers were displayed monitor (90%) vs without monitor (76%) (p<0.01). The air leakage from the mask reduced when the monitor was displayed (12%) vs without (30%). The PEEP improved when the health workers used monitor as guide to conduct neonatal resuscitation in the manikin then without monitor displayed. The participants felt more confident performing ventilations during the visible sessions. Conclusions: The ventilation function monitor helped participants to improve their ventilation skills through realtime feedback of important ventilation parameters. Clinical evaluation of needs to be done to assess the effectiveness of the device. Keywords: Clinical performance; monivent neo; neonatal resuscitation; Nepal; ventilation monitor.

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Effect of skill drills on neonatal ventilation performance in a simulated setting- observation study in Nepal

BMC Pediatrics ◽

10.1186/s12887-019-1723-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Rejina Gurung ◽

Abhishek Gurung ◽

Avinash K. Sunny ◽

Omkar Basnet ◽

Shree Krishna Shrestha ◽

...

Keyword(s):

Clinical Case ◽

Neonatal Resuscitation ◽

Ventilation Rate ◽

High Fidelity ◽

Mask Ventilation ◽

Observation Study ◽

Adequate Ventilation ◽

Effective Ventilation ◽

Ventilation Performance ◽

Bag And Mask Ventilation

Abstract Aim Maintaining neonatal resuscitation skills among health workers in low resource settings will require continuous quality improvement efforts. We aimed to evaluate the effect of skill drills and feedback on neonatal resuscitation and the optimal number of skill drills required to maintain the ventilation skill in a simulated setting. Methods An observational study was conducted for a period of 3 months in a referral hospital of Nepal. Sixty nursing staffs were trained on Helping Babies Breathe (HBB) 2.0 and daily skill drills using a high-fidelity manikin. The high-fidelity manikin had different clinical case scenarios and provided feedback as “well done” or “improvement required” based on the ventilation performance. Adequate ventilation was defined as bag-and-mask ventilation at the rate of 40–60 breaths per minute. The effective ventilation was defined as adequate ventilation with a “well done” feedback. We assessed the correlation of number skill drills and clinical case scenario with adequate ventilation rate using pearson’s correlation. We assessed the correlation of number of skill dills performed by each participant with effective ventilation using Mann Whitney test. Results Among the total of 60 nursing staffs, all of them were competent with an average score of 12.73 ± 1.09 out of 14 (p < 0.001) on bag-and-mask ventilation skill checklist. Among the trained staff, 47 staffs participated in daily skill drills who performed a total of 331 skill drills and 68.9% of the ventilations were done adequately. Among the 47 nursing staffs who performed the skill drills, 228 (68.9%) drills were conducted at a ventilation rate of 40–60 breathes per minute. There was no correlation of the adequate ventilation with skill drill category (p = 0.88) and the level of skill performed (p = 0.28). Out of 47 participants performing the skill drills, 74.5% of them had done effective ventilation with a mean average of 8 skill drills (SD ± 4.78) (p-value- 0.032). Conclusion In a simulated setting, participants who had an average skill drill of 8 in 3 months had effective ventilation. We demonstrated optimal skill drill sessions for maintain the neonatal resuscitation competency. Further evaluation will be required to validate the findings in a scale up setting.

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Predictors of mortality in premature babies with respiratory distress syndrome treated by early rescue surfactant therapy

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-190244 ◽

2021 ◽

pp. 1-6

Author(s):

V. Gahlawat ◽

H. Chellani ◽

I. Saini ◽

S. Gupta

Keyword(s):

Mechanical Ventilation ◽

Birth Weight ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Surfactant Therapy ◽

Mask Ventilation ◽

Predictors Of Mortality ◽

Antenatal Steroid ◽

Bag And Mask Ventilation

OBJECTIVE: To determine the predictors of mortality following early rescue surfactant therapy in preterm babies with respiratory distress syndrome. STUDY DESIGN: Prospective cohort study enrolling babies between 28 weeks to 34 weeks with respiratory distress syndrome requiring early rescue surfactant therapy. For statistical analysis babies were further divided into two subgroups: survivors and non-survivors. Maternal and neonatal variables were compared between the two groups to find out the predictors of mortality. RESULTS: Out of total 110 babies, 72 (65.45%) survived. The mean birth weight and mean gestational age of the study population was 1614.36 (±487.86) g and 31.40 (±2.0)1 weeks, respectively. Birth weight < 1500 g, gestational age < 32 weeks, primiparity, vaginal delivery, prolonged rupture of membranes, lack of antenatal steroid cover, bag and mask ventilation at birth, sepsis, apneic episodes and mechanical ventilation were significantly associated with death on univariate analysis. On multivariate analysis, very low birth weight, vaginal delivery, lack of antenatal steroid cover, bag and mask ventilation at birth and mechanical ventilation were found to be independent predictors of mortality. CONCLUSIONS: Some of the identified predictors of mortality are modifiable and can be used to draw up a screening tool to predict the clinical severity and mortality among these babies.

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Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd003314.pub2 ◽

2005 ◽

Cited By ~ 17

Author(s):

Andrew J. Grein ◽

Gary M Weiner

Keyword(s):

Laryngeal Mask Airway ◽

Endotracheal Intubation ◽

Neonatal Resuscitation ◽

Laryngeal Mask ◽

Mask Ventilation ◽

Bag Mask Ventilation

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Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd003314.pub3 ◽

2018 ◽

Cited By ~ 3

Author(s):

Mosarrat J Qureshi ◽

Manoj Kumar

Keyword(s):

Laryngeal Mask Airway ◽

Endotracheal Intubation ◽

Neonatal Resuscitation ◽

Laryngeal Mask ◽

Mask Ventilation ◽

Bag Mask Ventilation

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Neonatal resuscitation 3: manometer use in a model of face mask ventilation

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/adc.2004.064709 ◽

2005 ◽

Vol 90 (5) ◽

pp. F397-F400 ◽

Cited By ~ 16

Author(s):

C P F O'Donnell

Keyword(s):

Neonatal Resuscitation ◽

Face Mask ◽

Mask Ventilation

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The Effect of a Structured Neonatal Resuscitation Program on Delivery Room Practices

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.18.1.25 ◽

1999 ◽

Vol 18 (1) ◽

pp. 25-30 ◽

Cited By ~ 28

Author(s):

C. Anthony Ryan ◽

Lisa McCarthy Clark ◽

Aileen Malone ◽

Sami Ahmed

Keyword(s):

Thermal Protection ◽

Neonatal Resuscitation ◽

Heart Association ◽

Maternity Hospital ◽

Delivery Room ◽

Outcome Variable ◽

Main Outcome Variable ◽

Nurse Midwives ◽

Neonatal Resuscitation Program ◽

Bag And Mask Ventilation

Purpose: This study evaluated the introduction of the Neonatal Resuscitation Program (NRP) of the American Academy of Pediatrics and the American Heart Association into the delivery room of an Irish maternity hospital.Design: Prospective, controlled observational study of 51 deliveries before and 51 deliveries following the training of delivery room personnel in the NRP.Sample: Participants were 33 nurse-midwives and 11 pediatric resident physicians.Main outcome variable: Evaluation of postdelivery, newborn resuscitation practices.Results: The introduction of the NRP was associated with significant improvements in delivery room preparation, in the evaluation and management of the newborn infant, and in thermal protection at birth. Although there was a trend to use more free-flow oxygen following the introduction of the NRP, this was not statistically significant. Bag and mask ventilation was also used more frequently following NRP training. However, there were no significant differences in the use of endotracheal intubation, chest compressions, and medications. Fifteen of the 51 infants became hypothermic prior to the introduction of the NRP; none of the infants developed hypothermia in the post-NRP part of the study.

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Midwives' Evaluation of a Neonatal Resuscitation in High- and Low-Resource Settings

Frontiers in Pediatrics ◽

10.3389/fped.2021.644308 ◽

2021 ◽

Vol 9 ◽

Author(s):

Francesco Cavallin ◽

Serena Calgaro ◽

Martina Borellini ◽

Margherita Magnani ◽

Greta Beltramini ◽

...

Keyword(s):

Heart Rate ◽

Real Life ◽

Neonatal Resuscitation ◽

Educational Goals ◽

Mask Ventilation ◽

Central Hospital ◽

Chest Compressions ◽

Low Resource Settings ◽

Country Study ◽

Bag Mask Ventilation

Aim: To assess midwives' evaluation of a real-life neonatal resuscitation and their opinion on importance of resuscitation interventions.Methods: Multicenter, multi-country study.Setting: Beira Central Hospital (Mozambique) and Azienda Ospedale-Università di Padova (Italy).Subjects: Sixteen Mozambican midwives and 18 Italian midwives.Interventions: Midwives' assessment was evaluated by using a predefined score, which graded each resuscitation intervention (0–2 points) and summed to a total score for each step (initial steps, bag-mask ventilation, and chest compressions). All scores were compared with referral scores given by two expert neonatologists.Results: Both Mozambican and Italian midwives overestimated their performance regarding of initial steps taken during resuscitation, chest compressions, high-oxygen concentrations (p < 0.01), and underestimated the importance of stimulation (p < 0.05). Mozambicans overestimated suctioning (p < 0.001). Participants agreed with experts about the importance of equipment preparation, using a warmer, drying the newborn, removing wet linen and heart rate assessment.Conclusion: Mozambican and Italian midwives overestimated the performance of a real-life neonatal resuscitation, with heterogeneous evaluation of the importance of several aspects of neonatal resuscitation. These findings may be useful for identifying educational goals.

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