Delivery Room Intervention: Improving the Outcome
Section snippets
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
References (54)
- et al.
Neonatal resuscitation: toward improved performance
Resuscitation
(2002) - et al.
Neonatal intubation: success of pediatric trainees
J Pediatr
(2005) - et al.
Leadership of resuscitation teams: ‘Lighthouse Leadership’
Resuscitation
(1999) - et al.
Effect of polyethylene occlusive skin wrapping on heat loss in very low birthweight infants at delivery; a randomized trial
J Pediatr
(1999) - et al.
Accuracy of pulse oximetry measurement of heart rate of newborn infants in the delivery room
J Pediatr
(2008) Oxygen saturations immediately after birth
J Pediatr
(2006)- et al.
Oxygen saturation in healthy infants immediately after birth
J Pediatr
(2006) - et al.
Nasotracheal intubation in the neonate: physiologic responses and effects of atropine and pancuronium
J Pediatr
(1984) - et al.
Duration of intubation attempts during neonatal resuscitation
J Pediatr
(2004) - et al.
Comparison of methods of bag and mask ventilation for neonatal resuscitation
Resuscitation
(2001)
Risk factors for early death among extremely low-birth-weight infants
Am J Obstet Gynecol
Evaluation of the effectiveness of the standardized neonatal resuscitation program
J Perinatol
Video recording as a means of evaluating neonatal resuscitation performance
Pediatrics
Respiratory monitoring of neonatal resuscitation
Arch Dis Child Fetal Neonatal Ed
The evolution of Crew Resource Management training in commercial aviation
Int J Aviat Psychol
The development and testing of a performance checklist to assess neonatal resuscitation megacode skill
Pediatrics
Using video recording to identify management errors in pediatric trauma resuscitation
Pediatrics
Clinical assessment of infant colour at delivery
Arch Dis Child Fetal Neonatal Ed
The baby in the delivery room: a suitable microenvironment
JAMA
Using intensive care technology in the delivery room: a new concept for the resuscitation of extremely preterm neonates
Pediatrics
The EPICure Study: outcomes to discharge from hospital for infants born at the threshold of viability
Pediatrics
Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants
Cochrane Database Syst Rev
Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns
Acta Paediatr
Head insulation and heat loss in the newborn
Arch Dis Child
Cited by (28)
Learning with digital recording and video review of delivery room resuscitation
2022, Seminars in Fetal and Neonatal MedicineTackling Quality Improvement in the Delivery Room
2017, Clinics in PerinatologyCitation Excerpt :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 ControlCitation Excerpt :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, ResuscitationCitation Excerpt :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.
Integrative Review of Instruments to Measure Team Performance During Neonatal Resuscitation Simulations in the Birthing Room
2016, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal NursingPulse oximetry measures a lower heart rate at birth compared with electrocardiography
2015, Journal of PediatricsCitation Excerpt :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.