scholarly journals Assessment of ability of medical and obstetric students to achieve adequate positive pressure ventilation using basic neonatal resuscitation manikins

2021 ◽  
Vol 82 (3) ◽  
Author(s):  
Blanca Solis-Chimoy ◽  
Carlos A. Delgado ◽  
Roberto Shimabuku ◽  
Milagro Raffo
Keyword(s):  
Clinical Practice ◽  
Undergraduate Students ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Theory And Practice ◽  
Health Science ◽  
Positive Pressure ◽  
Clinical Activity ◽  
Ventilation Performance ◽  
Practice Assessment

Introduction. The ability to perform adequate positive pressure ventilation is necessary for neonatal clinical practice. However, there are few studies on the achievements of undergraduate students on this task. It is necessary to assess health science students’ adequate positive pressure ventilation because it is vital at the beginning of their clinical activity. Objective. To evaluate the cognitive and procedural ability related to adequate positive pressure ventilation performed by 6th year medicine students and 4th year obstetrics students at a public university in Lima, Peru. Methods. We surveyed 78 medical and obstetric students in their last years of studies within six months of taking a course on neonatal resuscitation that included positive pressure ventilation theory and practice. Participants voluntarily agreed to participate in this study. Previously, we validated the survey by asking three experienced neonatologists for their expert judgments on improving the survey. The survey consists of three theoretical questions as a cognitive assessment and three practice assessment criteria qualified by observing performance using neonatal manikins. Results. Medicine students had a better practical ability (p <0.001) than obstetrics students, and obstetrics students presented better theoretical knowledge (p = 0.019). However, both groups achieved limited performance within six months of taking the neonatal clinical practice course as 21.8% of all students passed both the theoretical and practical parts of this study. Conclusion. Participants from both schools require further training alternatives to achieve adequate positive pressure ventilation performance.

scholarly journals Non-invasive positive pressure ventilation in acute hypercapnic respiratory failure: clinical experience of a respiratory ward

2004 ◽  
Vol 61 (2) ◽  
Author(s):  
R. Scala ◽  
M. Naldi ◽  
I. Archinucci ◽  
G. Coniglio
Keyword(s):  
Clinical Practice ◽  
Respiratory Failure ◽  
Standard Therapy ◽  
Positive Pressure Ventilation ◽  
Controlled Trial ◽  
Positive Pressure ◽  
Hypercapnic Respiratory Failure ◽  
Non Invasive ◽  
Arterial Blood ◽  
Acute Hypercapnic Respiratory Failure

Background: Although a controlled trial demonstrated that non-invasive positive pressure ventilation (NIV) can be successfully applied to a respiratory ward (RW) for selected cases of acute hypercapnic respiratory failure (AHRF), clinical practice data about NIV use in this setting are limited. The aim of this observational study is to assess the feasibility and efficacy of NIV applied to AHRF in a RW in everyday practice. Methods: Twenty-two percent (216/984) of patients consecutively admitted for AHRF to our RW in Arezzo (years: 1996-2003) received NIV in addition to standard therapy, according to pre-defined routinely used criteria. Tolerance, effects upon arterial blood gases (ABG), success rate (avoidance a priori criteria for intubation) and predictors of failure of NIV were analysed. Results: Nine patients (4.2%) were found to be intolerant to NIV, while the remaining 207 (M: 157, F: 50; mean (SD) age: 73.2 (8.9) yrs; COPD: 71.5%) were ventilated for &gt;1 hour. ABG significantly improved after two hours of NIV (pH: 7.32 (0.06) versus median (Interquartiles) 7.28 (7.24-7.31), p&lt;0.0001; PaCO2: 71.9 (13.5) mmHg versus 80.0 (15.2) mmHg, p&lt;0.0001; PaO2/FiO2: 212 (66) versus 184 (150-221), p&lt;0.0001). NIV succeeded in avoiding intubation in 169/207 patients (81.6%) with hospital mortality of 15.5%. NIV failure was independently predicted by Activity of Daily Living score, pneumonia as cause of AHRF and Acute Physiology and Chronic Health Evaluation III score. Conclusions: In clinical practice NIV is feasible, effective in improving ABG and useful in avoiding intubation in most AHRF episodes that do not respond to the standard therapy managed in an RW adequately trained in NIV.

Neonatal Resuscitation

2021 ◽  
pp. 177-182
Author(s):  
Sarah Nizamuddin
Keyword(s):  
Heart Rate ◽  
Respiratory Distress ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Respiratory Effort ◽  
Chest Compressions ◽  
Adequate Ventilation

After birth, the neonate must be immediately examined to evaluate the need for further resuscitation. Presence of an adequate respiratory effort and heart rate is vital, in addition to adequate tone and temperature. Warm, dry, and closely monitor the infant immediately after birth. Give positive pressure ventilation if there are any signs of respiratory distress or bradycardia. Low heart rate in a neonate is almost always due to hypoxia, so establish adequate ventilation as soon as possible in these cases. In cases of continued bradycardia, chest compressions and medication (epinephrine) may be necessary. Following resuscitation, transfer the neonate to an appropriate unit for continued monitoring.

scholarly journals Reply to: Noninvasive positive pressure ventilation after extubation: features and outcomes in clinical practice

2016 ◽  
Vol 28 (1) ◽  
Author(s):  
Liria Yuri Yamauchi ◽  
Maise Figueiroa ◽  
Leda Tomiko Yamada da Silveira ◽  
Teresa Cristina Francischetto Travaglia ◽  
Sidnei Bernardes ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure

Approach to Infants Born Through Meconium Stained Amniotic Fluid: Evolution Based on Evidence?

2018 ◽  
Vol 35 (09) ◽  
pp. 815-822 ◽  
Author(s):  
Sushma Nangia ◽  
Praveen Chandrasekharan ◽  
Satyan Lakshminrusimha ◽  
Munmun Rawat
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Positive Pressure ◽  
Randomized Controlled Studies ◽  
Randomized Control ◽  
Meconium Stained Amniotic Fluid ◽  
Ischemic Encephalopathy

AbstractMeconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator. The recent neonatal resuscitation program (NRP) recommends against suctioning but favors resuscitation with positive pressure ventilation of nonvigorous neonates with MSAF. This recommendation is aimed to prevent delay in resuscitation and minimize hypoxia-ischemia often associated with MSAF. In this review, we discuss the pathophysiology, evolution and the evidence, randomized control trials, observational studies, and translational research to support these recommendations. The frequency of ECMO use for neonatal respiratory indication of MAS has declined over the years probably secondary to improvements in neonatal intensive care and reduction of postmaturity. Changes in resuscitation practices may have contributed to reduced incidence and severity of MAS. Larger randomized controlled studies are needed among nonvigorous infants with MSAF. However, ethical dilemmas and loss of equipoise pose a challenge to conduct such studies.

scholarly journals Improvement of Immediate Performance in Neonatal Resuscitation Through Rapid Cycle Deliberate Practice Training

2018 ◽  
Vol 10 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Maclain J. Magee ◽  
Christiana Farkouh-Karoleski ◽  
Tove S. Rosen
Keyword(s):  
Confidence Level ◽  
Primary Outcome ◽  
Positive Pressure Ventilation ◽  
Deliberate Practice ◽  
Neonatal Resuscitation ◽  
Secondary Outcome ◽  
Positive Pressure ◽  
Cumulative Score ◽  
Simulation Session ◽  
Academic Training Program

ABSTRACT Background  Simulation training is an effective method to teach neonatal resuscitation (NR), yet many pediatrics residents do not feel comfortable with NR. Rapid cycle deliberate practice (RCDP) allows the facilitator to provide debriefing throughout the session. In RCDP, participants work through the scenario multiple times, eventually reaching more complex tasks once basic elements have been mastered. Objective  We determined if pediatrics residents have improved observed abilities, confidence level, and recall in NR after receiving RCDP training compared to the traditional simulation debriefing method. Methods  Thirty-eight pediatrics interns from a large academic training program were randomized to a teaching simulation session using RCDP or simulation debriefing methods. The primary outcome was the intern's cumulative score on the initial Megacode Assessment Form (MCAF). Secondary outcome measures included surveys of confidence level, recall MCAF scores at 4 months, and time to perform critical interventions. Results  Thirty-four interns were included in analysis. Interns in the RCDP group had higher initial MCAF scores (89% versus 84%, P &lt; .026), initiated positive pressure ventilation within 1 minute (100% versus 71%, P &lt; .05), and administered epinephrine earlier (152 s versus 180 s, P &lt; .039). Recall MCAF scores were not different between the 2 groups. Conclusions  Immediately following RCDP interns had improved observed abilities and decreased time to perform critical interventions in NR simulation as compared to those trained with the simulation debriefing. RCDP was not superior in improving confidence level or retention.

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