Thank you for this great video on the 8th Edition NRP guidelines. Your video is short and concise providing what we need to know related to the changes. Keep up the great work with your videos.
Thank you for taking the time to watch and comment on this video. We try to make it as simple as possible for HCP'S to learn the latest resuscitation guidelines.
Hello! Thanks so much for the wonderful presentation. Would you please make a video for those of us, providers, that practice outside of the hospital. Out of hospital birth attendants must be proficient in NRP, to the level of mastery. However, there are not many programs which cater to births that are happening outside of the hospital… For example home birth, or birth in a birth center with Midwives. When we are in the out of hospital setting, we do not have a button that we can push, where in nurses will come flying in to attend to the baby. There are usually two providers present at an out of hospital birth. A midwife, which is the healthcare provider, and a midwife assistant which is either an RN, or a MIDWIFERY student who is trained in Birth assistance. Since we do not have a code button where providers are rushing in to perform neonatal resuscitation, it is important that we have specific training and practice for a two person team, outside of the hospital setting. Would you please make a video which caters to this specific situation and scenario. We are all trained and certified in an RP, and we must recertify every two years, but the problem is that a very minuscule percentage of babies born outside of the hospital would ever need any stage of NRP, especially beyond the first few rescue breaths. We do not have a lot of practice with an RP, which can be a good thing and a bad thing at the same time, and this is due to the fact that we are performing continuous ongoing risk assessment in the antepartum. Are people that are giving birth outside of the hospital are the lowest of the low risk population. We do not see many bad outcomes due to risk level. Out of hospital providers take the same training as in hospital providers, even though our scenarios look much more different than the hospital does. It is unfortunate that the AAP only gears there NRP towards hospital birth, when out of hospital birth is only going to continue to rise. Especially during the pandemic, out of hospital birth rates increased significantly. Out of hospital birth is here, it has always been here, and it is here to stay.
Also, it is imperative that we educate our emergency medical techs. EMTs rarely understand the difference between NRP, and infant CPR. For example in the out of hospital setting we may perform neonatal resuscitation on a neonate, and if they need anything beyond PPV… For example if we must perform chest compressions… We activate EMS immediately as we continue to perform neonatal resuscitation and hopefully stabilize the neonate. One of the major issues that we have, is that when EMS arrives, they want to take over resuscitation efforts, but they are not trained properly in neonatal resuscitation and they end up harming the neonate by performing infant CPR. Moreover, some EMS will refuse to allow the midwife or the assistant to continue performing neonatal resuscitation even though they are the most trained person present. There are many horror stories of midwives performing neonatal resuscitation, and upon arrival of EMS, they demand to take over, and the baby crashes on the way to the hospital. This should not be the case in 2023. Every EMT and or medic should be fully proficient in neonatal resuscitation and understand the difference between neonatal resuscitation and infant CPR. They are causing harm, and we need to come together and train properly for these instances. People can stick to their one track thinking, and proclaim that birth should not happen outside of a hospital, but the fact of the matter is that people will always always choose out of hospital birth, and we are not going to talk people into birthing inside of a hospital if they do not desire to do so. So instead of staying in a one track mind and saying how dangerous it is to birth outside of the hospital, we need to come together and make it safer by focusing on integration among the many different categories of providers, as well as birth setting.
Thank you for your feedback. We will see what we can do for the out of hospital 🏥 providers. Do you have any specific items that you would like to be covered in a video?
@@nikisawyers7559 We have made a high-level overview video on out-of-hospital NRP management. Please have a look:ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-FsAHE7rdvfo.html Let me know what else we can add in a future video on NRP
Thank you for you comment. I'm not a Neonatologist but someone who is passionate about Neonatal resuscitation and Neonatal resuscitation training. Thank you for watching.
You can give Epinephrine [1mg/10ml concentration] every 3-5 minutes if indicated. If you started with the lower side of the dosage range you could increase the dose to the higher end of the recommendation if there is not a good response. So there is no limit on how many times you can repeat during resuscitation.
Some Antepartun Risk Factors can include: Gestational age less than 36 weeks; gestational age equal or greater than 41 weeks; preeclampsia; no prenatal care. Intrapartum Risk Factors: Emergency C- section; Forceps or vacuum-assisted delivery; Breech, Mechonium Stained amniotic fluid; prolapse cord; Placental abduction. Refer to the NRP Manual 8 edition- Lesson 2- page 15.
