Delivery Room Intervention: Improving the Outcome

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Video Recording

We initiated a quality improvement program in 1999 and began to video record neonatal resuscitations in our dedicated resuscitation suite and 1 additional obstetric operating room.2 Our ongoing quality improvement program involving the video and analog data recording of high-risk deliveries and the subsequent review of such resuscitations,3 and our prospective database of all neonatal intubations,4 have allowed us to critically evaluate and modify our own practices, and the resuscitation

The Team

When evaluating team function, 2 distinct outcomes should be measured. These include evaluating whether the intervention was the correct one, and whether the intervention was performed correctly. Initial video review of resuscitations at the University of California San Diego Medical Center revealed several problems in the conduct of the resuscitation involving the team, the leader, or both. These problems included more than 1 person doing a single task; other tasks that were not performed at

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References (54)

  • S. Shankaran et al.

    Risk factors for early death among extremely low-birth-weight infants

    Am J Obstet Gynecol

    (2002)
  • N. Singhal et al.

    Evaluation of the effectiveness of the standardized neonatal resuscitation program

    J Perinatol

    (2001)
  • D.N. Carbine et al.

    Video recording as a means of evaluating neonatal resuscitation performance

    Pediatrics

    (2000)
  • G.M. Schmölzer et al.

    Respiratory monitoring of neonatal resuscitation

    Arch Dis Child Fetal Neonatal Ed

    (2009)
  • Cooper GE, White MD, Lauber JK. Resource management on the flightdeck: Proceedings of a NASA/Industry Workshop. (NASA...
  • R. Helmreich et al.

    The evolution of Crew Resource Management training in commercial aviation

    Int J Aviat Psychol

    (1999)
  • J. Lockyer et al.

    The development and testing of a performance checklist to assess neonatal resuscitation megacode skill

    Pediatrics

    (2006)
  • E. Oakley et al.

    Using video recording to identify management errors in pediatric trauma resuscitation

    Pediatrics

    (2006)
  • C.P. O'Donnell et al.

    Clinical assessment of infant colour at delivery

    Arch Dis Child Fetal Neonatal Ed

    (2007)
  • J.N. Du et al.

    The baby in the delivery room: a suitable microenvironment

    JAMA

    (1969)
  • Kimball A, Leone TA, Vaucher Y, et al. Admission status of extremely low birth weight (ELBW) infants over the last five...
  • M. Vento et al.

    Using intensive care technology in the delivery room: a new concept for the resuscitation of extremely preterm neonates

    Pediatrics

    (2008)
  • K. Costeloe et al.

    The EPICure Study: outcomes to discharge from hospital for infants born at the threshold of viability

    Pediatrics

    (2000)
  • E.M. McCall et al.

    Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants

    Cochrane Database Syst Rev

    (2008)
  • Flenady VJ, Woodgate PG. Radiant warmers versus incubators for regulating body temperature in newborn infants Cochrane...
  • N.J. Bergman et al.

    Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns

    Acta Paediatr

    (2004)
  • J.K. Stothers

    Head insulation and heat loss in the newborn

    Arch Dis Child

    (1981)
  • Cited by (28)

    • Tackling Quality Improvement in the Delivery Room

      2017, Clinics in Perinatology
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      A recording system and procedures that can ensure confidentiality for both patients' families and personnel are crucial. In the UCSD program, video recordings are erased at most 14 days after the event.15 Centers like UCSD have determined that video recording in the delivery room for QI does not require family consent, because it is for the purpose of QI and adequate protections for privacy have been established.

    • Automatic classification of resuscitation activities on birth-asphyxiated newborns using acceleration and ECG signals

      2017, Biomedical Signal Processing and Control
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      Various features, e.g., features in time domain [10–13] or frequency domain [15] or both [16,14], were extracted from acceleration signals measured by the devices worn tightly on the body and the activities typically categorized were running, walking, standing, sitting, and jumping. To identify activities having significant impacts on the improvement of asphyxiated newborns during resuscitation, it is necessary to study videos recorded in the delivery room [17,18]. However, in practical situations, video recordings are not likely to be available, and video reviewing is very time consuming.

    • Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital

      2017, Resuscitation
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      Globally, the cause of over 1 million neonatal deaths each year is birth asphyxia, or failure for the baby to breathe on its own after birth [1–3]. Birth asphyxia is a life-threatening emergency in newborns that requires prompt resuscitative action in approximately 3–6% of otherwise healthy babies [2,4–6]. Basic neonatal resuscitation with a bag-and-mask to provide positive pressure ventilation (PPV) is required to support the perinatal transition until the newborn’s control of breathing improves.

    • Pulse oximetry measures a lower heart rate at birth compared with electrocardiography

      2015, Journal of Pediatrics
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      However, we were able to include data of 11 infants at 60 seconds and 24 infants at 90 seconds. Although it has been shown that PO effectively provides oxygen saturation and HR in newborns,6,15 several studies reported that at birth reliable signals were rarely available within 60 to 120 seconds after birth.2,4,6,16,17 However, we managed to collect data with good signal quality in a considerable number of newborns during this time period.

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