Most live births proceed without difficulty, but up to 10% will need aggressive interventions, including assistance with breathing. While out-of-hospital deliveries are rare, this low-frequency, high-risk scenario can present EMS providers with specific challenges.
Recent studies have shown that they often lack training and practice opportunities in neonatal resuscitation techniques. As such, simulation can be a useful learning modality to train and enhance EMS providers’ skill sets in neonatal resuscitation and ensure newborns receive safe and effective care.
EMS Providers Lack Training in Neonatal Resuscitation Protocols
A study published in the July 2020 issue of Pediatrics found that providers lacked knowledge of and practice in neonatal resuscitation protocols (NRP).
The study found that EMS providers rarely performed basic protocols like drying, warming, and stimulating within the first 30 seconds after birth, as recommended by NRP guidelines. They also often supplemented respiration at a rate too slow to provide adequate neonatal resuscitation.
Timing is key to a positive outcome for an infant born in the prehospital setting. Providers have about a minute after birth to evaluate and stimulate the newborn and begin interventions if they are not breathing.
However, since neonatal resuscitation happens so infrequently outside of a hospital, EMS providers do not normally have the opportunity to practice these skills. As a result, appropriate care can be delayed and cause poor outcomes for the patient.
NRP Training Overlooked in EMS Education Programs
Furthermore, 66% of EMS providers report that they had never received NRP training or that their last training was over two years ago. Skills and knowledge deteriorate if they are not utilised frequently, so providers fall back on skills they use most often in the field.
For example, they will use adult resuscitation protocols like ACLS on newborns despite their different physiology.
Therefore, EMS programs must include neonatal training in their curriculum and offer skill refresher training periodically. Since providers have limited exposure to newborns in the field, simulation-based training can help to fill that gap and give them valuable experiences.
Likewise, providers can practice and gain proficiency in neonatal resuscitation, so vital actions are not missed when a real emergency event occurs.
Utilising Simulation to Teach and Help Retain Newborn Resuscitation Skills
Just as nursing and medical programs struggle to provide relevant clinical experiences, EMS programs face similar challenges. Besides, it would be unethical for an inexperienced provider to treat a newborn patient.
However, without exposure to newborn and school-aged patients, EMS providers do not have an opportunity to practice and develop the specific skills needed to treat those patients.
In response, the National Association of EMS Educators (NAEMSE) released a Vision Paper supporting replacing some clinical hours with time spent working on simulators. The paper argues that simulation allows learners to gain experience providing care for various clinical scenarios in newborn patients.
For example, cases involving neonatal resuscitation are high-stress and require quick action from providers. Simulated scenarios can recreate the stress and demands of real emergencies, so learners respond as they would in the field.
As they repeatedly rehearse on the simulator, learners become familiar with newborn physiology, develop routines, and practice safe behaviours, thereby improving their decision-making skills and response time.
Gaumard’s Turnkey Obstetric Simulators
Gaumard has a full suite of training products for Obstetrics and Gynecology, including VICTORIA®, a high fidelity childbirth simulator; her baby, SUPER TORY®; and skills trainers such as SUSIE®, a childbirth torso; and Zoe®, for gynecologic skills training.
Earlier this year, Gaumard launched Obstetric MR™ for VICTORIA®, a new mixed reality training solution consisting of a HoloLens 2 headset computer.
The comprehensive mixed reality system uses advanced holographic imaging technology to allow the wearer to see inside VICTORIA® and observe the dynamic physiology and anatomy underlying difficult deliveries.
To learn more about Gaumard or any of the brand’s obstetric simulators, you can visit our page at https://bmec.asia/my/gaumard/
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Eddy Bermudez, Editor at Gaumard Scientific
