A Survey of Academic Neonatologists on Neonatal Electrical Cardioversion and Defibrillation

Area of Science:

• Neonatal Medicine
• Cardiology
• Medical Education

Background:

• Neonatal electrical cardioversion or defibrillation (EC-D) is a critical intervention.
• Assessing neonatologists' proficiency and comfort with EC-D is essential for patient care.
• Current training and certification practices may not adequately prepare neonatologists for EC-D procedures.

Purpose of the Study:

• To evaluate the experience and comfort levels of academic neonatologists with neonatal electrical cardioversion or defibrillation (EC-D).
• To identify factors associated with comfort or discomfort in performing EC-D.
• To inform recommendations for improving EC-D training and competency.

Main Methods:

• An electronic survey was distributed to academic neonatologists at 12 Midwest hospitals.
• The survey assessed residency training, recent certifications (Basic Life Support [BLS], Pediatric Advanced Life Support [PALS], Advanced Cardiovascular Life Support [ACLS], Neonatal Resuscitation Program [NRP]), EC-D experience, and comfort levels.
• Statistical analyses, including odds ratios, were used to evaluate factors influencing comfort.

Main Results:

• A 40% response rate (72/180) was achieved. Most neonatologists (73.6%) had performed EC-D, but 50.9% of those felt uncomfortable.
• Lack of BLS certification was associated with decreased comfort (OR: 0.269).
• Greater volume and recency of EC-D experience correlated with increased comfort.

Conclusions:

• Half of neonatologists who perform EC-D report discomfort, highlighting a training gap.
• BLS certification and practical experience are key factors in improving comfort with EC-D.
• Regular simulation-based training in EC-D is recommended to enhance neonatologists' confidence and competence.