Document Detail


Observations from 450 shoulder dystocia simulations: lessons for skills training.
MedLine Citation:
PMID:  18827135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Poor neonatal outcomes after shoulder dystocia have been associated with inappropriate management. Until there are significant developments in the prediction and subsequent prevention of shoulder dystocia, improving shoulder dystocia management through practical training may be the most effective method of reducing the associated morbidity and mortality. Four hundred fifty simulated shoulder dystocia scenarios, managed by 95 midwives and 45 doctors from six U.K. hospitals during the course of 1 year, were video recorded during a study of obstetric emergency training. Analysis of recorded data revealed that, before training, 57% were unable to deliver the baby, almost two thirds failed to call for pediatric support, and 1 in 27 used fundal pressure. Recurring difficulties in management were observed: poor communication, inability to gain internal access, confusion over internal maneuvers, and the application of excessive traction. Significant improvements in management were observed after training and persisted up to 1 year after training. The lessons learned from this study can inform and improve future training and management. This article describes difficulties encountered by the participants and discusses how training may be focused to address these problems.
Authors:
Joanna F Crofts; Robert Fox; Denise Ellis; Catherine Winter; Kim Hinshaw; Timothy J Draycott
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  112     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-01     Completed Date:  2008-11-06     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  906-12     Citation Subset:  AIM; IM    
Affiliation:
Departments of Obstetrics and Gynaecology, Musgrove Park Hospital, Taunton, United Kingdom. jocrofts@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Birth Injuries / prevention & control*
Clinical Competence*
Communication
Delivery, Obstetric / methods
Documentation
Dystocia / therapy*
Education, Medical, Continuing
Emergency Medical Services
Female
Humans
Obstetrics / education*
Pregnancy
Pregnancy Complications
Shoulder / injuries*
Grant Support
ID/Acronym/Agency:
//Department of Health
Comments/Corrections
Comment In:
Obstet Gynecol. 2008 Oct;112(4):746-7   [PMID:  18827114 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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