Document Detail

The development and implementation of a multidisciplinary neonatal resuscitation team in a Canadian perinatal centre.
MedLine Citation:
PMID:  15993729     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the implementation of a multidisciplinary neonatal resuscitation team (NRT) at a Canadian tertiary perinatal centre. METHODS: In February 2002, the primary role of neonatal resuscitation was transferred from attending physicians (on-call off-site) to a NRT (consisting of a neonatal intensive care nurse, a respiratory therapist, and, when available, a resident, clinical associate (supervised licensed physician), or nurse practitioner). The NRT attended moderate- and high-risk deliveries (in the latter case, accompanied by a neonatologist). Normal, low-risk deliveries remained the responsibility of caseroom (delivery room) staff, assisted by the NRT when concerns arose. A prospective assessment was performed of resuscitation requirements and outcomes. RESULTS:: Over 24 months, the NRT attended 2944 (64.5%) out of 4565 deliveries. The NRT attended 2497 moderate-risk deliveries, providing positive pressure ventilation (in 15.7% of cases), chest compressions (0.1%), and epinephrine (adrenaline) (0.08%). There were no neonatal deaths or morbidities related to resuscitation in this cohort. A small, but significant, proportion of babies with no identifiable risk factors required resuscitation by caseroom staff (in most cases with brief periods of positive pressure ventilation). CONCLUSION: Assignment of level of risk provides a safe means of delivering neonatal resuscitation services, facilitating NRT attendance at the majority of deliveries that required resuscitation. A NRT can perform safely and effectively in a tertiary perinatal centre with off-site support from experienced neonatal staff at high-risk deliveries only. Caseroom (delivery room) staff should continue to be trained in neonatal resuscitation.
Khalid Aziz; Mairi Chadwick; Geoff Downton; Mary Baker; Wayne Andrews
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  66     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-11-10     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  45-51     Citation Subset:  IM    
Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, St. John's NL, Canada A1B 3V6.
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MeSH Terms
Analysis of Variance
Cardiopulmonary Resuscitation / methods,  standards
Chi-Square Distribution
Clinical Competence / standards
Delivery Rooms / standards
Infant, Newborn
Intensive Care Units, Neonatal / standards*,  statistics & numerical data
Newfoundland and Labrador
Patient Care Team / standards*
Resuscitation / methods*,  standards*,  statistics & numerical data

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