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Updated: May 21, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessing posture and fatigue during neonatal positive pressure ventilation

Jacqueline Hannan1, Gary Weiner2, Leia Stirling3

  • 1Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA.

Applied Ergonomics
|March 21, 2025
PubMed

Healthcare professionals (HCPs) are often required to complete their work under suboptimal ergonomic conditions in critical situations, inducing fatigue and musculoskeletal injury risk. These risks may vary depending on equipment and technique choices, which could require differing postures. Neonatal positive pressure ventilation (PPV) is administered to newborns who require resuscitation by holding a face mask over the nose and mouth and forcing air into the lungs with a device, such as a T-piece or a self-inflating bag (SIB). This study assessed if varying PPV device type and mask hold strategies impacted fatigue and musculoskeletal injury risk. Results show that using a SIB caused more frequent forearm extensor muscle fatigue (47.61% of trials) compared to the T-piece (14.29% of trials) and increased shoulder musculoskeletal injury risk (mean shoulder elevation angles: 45.58°(SIB) vs. 27.29°(T-piece)). When these devices are clinically comparable, the T-piece should be implemented for improved ergonomic outcomes.

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