Impact of a novel decision support tool on adherence to Neonatal Resuscitation Program algorithm
2015; 88: 52-56
On the need for precise, concise communication during resuscitation: a proposed solution.
journal of pediatrics
2015; 166 (1): 184-187
The Neonatal Resuscitation Program: Current Recommendations and a Look at the Future
INDIAN JOURNAL OF PEDIATRICS
2014; 81 (5): 473-480
Studies have shown that healthcare professionals (HCPs) display a 16-55% error rate in adherence to the Neonatal Resuscitation Program (NRP) algorithm. The aim of this study was to evaluate adherence to the Neonatal Resuscitation Program algorithm by subjects working from memory as compared to subjects using a decision support tool that provides auditory and visual prompts to guide implementation of the Neonatal Resuscitation Program algorithm during simulated neonatal resuscitation.Healthcare professionals (physicians, nurse practitioners, obstetrical/neonatal nurses) with a current NRP card were randomized to the control or intervention group and performed three simulated neonatal resuscitations. The scenarios were evaluated for the initiation and cessation of positive pressure ventilation (PPV) and chest compressions (CC), as well as the frequency of FiO2 adjustment. The Wilcoxon rank sum test was used to compare a score measuring the adherence of the control and intervention groups to the Neonatal Resuscitation Program algorithm.Sixty-five healthcare professionals were recruited and randomized to the control or intervention group. Positive pressure ventilation was performed correctly 55-80% of the time in the control group vs. 94-95% in the intervention group across all three scenarios (p<0.0001). Chest compressions were performed correctly 71-81% of the time in the control group vs. 82-93% in the intervention group in the two scenarios in which they were indicated (p<0.0001). FiO2 was addressed three times more frequently in the intervention group compared to the control group (p<0.001).Healthcare professionals using a decision support tool exhibit significantly fewer deviations from the Neonatal Resuscitation Program algorithm compared to those working from memory alone during simulated neonatal resuscitation.
View details for DOI 10.1016/j.resuscitation.2014.12.016
View details for Web of Science ID 000352508400023
When operating is considered futile: Difficult decisions in the neonatal intensive care unit
2009; 146 (1): 122-125
Effect of antiplatelet therapy on thromboembolic complications of elective coil embolization of cerebral aneurysms
AMERICAN JOURNAL OF NEURORADIOLOGY
2007; 28 (9): 1778-1782
The Neonatal Resuscitation Program (NRP) consists of an algorithm and curriculum to train healthcare professionals to facilitate newborn infants' transition to extrauterine life and to provide a standardized approach to the care of infants who require more invasive support and resuscitation. This review discusses the most recent update of the NRP algorithm and recommended guidelines for the care of newly born infants. Current challenges in training and assessment as well as the importance of ergonomics in the optimization of human performance are discussed. Finally, it is recommended that in order to ensure high-performing resuscitation teams, members should be selected and retained based on objective performance criteria and frequent participation in realistic simulated clinical scenarios.
View details for DOI 10.1007/s12098-013-1332-0
View details for Web of Science ID 000335739000011
View details for PubMedID 24652267
Thromboembolic events are the most common complications of elective coil embolization of cerebral aneurysms. Administration of oral clopidogrel and/or aspirin could lower the thromboembolic complication rate.Records over a 10-year period were reviewed in a retrospective cohort study. For 369 consecutive elective coil embolization procedures, 25 patients received no antiplatelet drugs, 86 received antiplatelet drugs only after embolization, and 258 received antiplatelet drugs before and after embolization.Symptomatic thromboembolic complications (transient ischemic attack or stroke within 60 days) occurred in 4 (16%) of 25 when no antiplatelet drugs were given, in 2 (2.3%) of 86 when antiplatelet drugs were administered only after embolization, and in 5 (1.9%) of 258 when antiplatelet drugs were administered before and after embolization. The lower symptomatic thromboembolic complication rate in the patients who received any antiplatelet therapy was statistically significant (P = .004). Clots were visible intraprocedurally in 5 (4.5%) of 111 when no antiplatelet drugs were administered before procedures and in 4 (1.6%) of 258 when they were (P value not significant). None of the 9 was symptomatic postprocedurally, but 7 were lysed or mechanically disrupted. Extracerebral hemorrhagic complications occurred in 0 (0%) of 25 when no antiplatelet drugs were given and in 11 (3.2%) of 344 when they were (P value not significant).Oral clopidogrel and/or aspirin significantly lowered the symptomatic thromboembolic complication rate of elective coil embolization of unruptured cerebral aneurysms. There were trends toward a lower rate of intraprocedural clot formation in patients given antiplatelet drugs before procedures and a higher hemorrhagic complication rate in patients given antiplatelet drugs. Benefits of antiplatelet therapy appear to outweigh risks.
View details for DOI 10.3174/ainr.A0641
View details for Web of Science ID 000250312200035
View details for PubMedID 17885244