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The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation
Published on: August 15, 2018
Evaluating the Effectiveness of an Evidence-Based Practice in Neonatal Resuscitation among Birth Asphyxiated Newborns
Lydia Boampong Owusu1, Joseph Shahadu Issifu1, Emmanuel Odame Owiredu2
1School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Insights
Effective neonatal resuscitation in the first minute is crucial for newborn outcomes. This study highlights the strong association of initial resuscitation techniques with early APGAR scores, emphasizing the need for skilled midwives.
Area of Science:
- Neonatal care and perinatal medicine.
- Evidence-based practice in obstetrics.
- Public health and newborn survival strategies.
Background:
- The World Health Organization stresses the critical "golden minute" for neonatal resuscitation.
- Effective resuscitation impacts immediate and long-term newborn health, particularly for those with asphyxia.
- Evaluating current resuscitation techniques is essential to optimize newborn outcomes.
Purpose of the Study:
- To assess the effectiveness of various neonatal resuscitation techniques.
- To analyze the association between resuscitation methods and newborn outcomes, specifically APGAR scores.
- To inform best practices in perinatal care for asphyxiated neonates.
Main Methods:
- A cross-sectional observational study involving 254 newborns across five hospitals.
- Data collection included delivery observations and immediate newborn care from April to June 2022.
- Statistical analysis utilized descriptive methods and Cramer's V test to assess associations with APGAR scores.
Main Results:
- Midwives performed 98.4% of neonatal resuscitations.
- Common initial measures included drying, warming, and back rubbing; 46% received bag and mask ventilation.
- Strong associations were found between initial resuscitation actions (drying, warming, back rubbing) and the first-minute APGAR score (p < .0001).
Conclusions:
- Neonatal resuscitation is significantly more effective within the first minute post-birth.
- Continuous training for midwives is vital for timely and efficient newborn resuscitation.
- Further research into advanced resuscitation methods and technology is recommended to improve outcomes beyond the initial minute.
Introduction:
The World Health Organization emphasizes that neonatal resuscitation performed in the first "golden minute" following birth can influence both immediate and long-term outcomes of newborns, especially asphyxiated ones. The modes of resuscitation, which is an evidenced-based practice, require evaluation to identify their effectiveness.
Objectives:
This study evaluated neonatal resuscitation techniques and their effectiveness in the management of asphyxiated neonates during the perinatal period.
Design:
Cross-sectional design with observation of delivery and immediate care of 254 newborns in five hospitals from April to June 2022.
Methods:
Neonatal resuscitation and demographic characteristics were noted. Data were analyzed descriptively using STATA 17 and Cramer's V test of association between APGAR scores and resuscitation modes was done with statistical significance established at p ≤ .05.
Results:
Neonatal resuscitation was primarily performed by midwives (98.4%), with 48.8% of the infants resuscitated after birth. The most common modalities of resuscitation were drying, keeping warm, rubbing the back, and flicking the feet, with 46.0% started on bag and mask ventilation. The success rate of resuscitation was impressive (58.1%), satisfactory (38.7%), and poor (3.2%). There was a strong association of the first minute APGAR score with drying the neonate (p = .0001, φc = 0.619), keeping the neonate warm, and rubbing the back of the neonate (p = .0001, φc = 0.613). However, their association with the fifth minute APGAR score was weak (p = .002, φc = 0.222). Feet flicking has no significant association with the fifth minute APGAR score.
Conclusion:
Neonatal resuscitation, which is an evidence-based practice, is more effective in the first minute than in the fifth minute. Regular training of midwives to update their resuscitation skills is important to promote timely and efficient resuscitation of newborns. Further studies into the advancements in resuscitation modes and the use of technology to improve resuscitation beyond the first minute are recommended.
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