Delivery Room Resuscitation

Published Date: 19th July 2016

Publication Authors: Whitby TM

​Background

In 2011, on the basis of clinical research studies, the Resuscitation Council (UK) recommended that term infants should be resuscitated initially in room air, and preterm infants in blended oxygen guided by pulse oximetry.

Aims

We aimed to examine whether UK hospitals follow the Resuscitation Council 2011 (UK) guidelines and how quickly new practices are implemented.

Methods

In March 2011 a telephone survey of delivery room resuscitation practice was undertaken in all UK NHS hospitals that provide neonatal services. All units that had resuscitated infants in 100 % FiO2 were re-surveyed in March 2012. Senior neonatal nurses or paediatricians were interviewed.

Results

Of 208 hospitals contacted in 2011, 195 (93.8 %) participated. Of these, 70 (35.9 %) resuscitated neonates initially in 100 %

FiO2. In 2012, of the 70 hospitals resurveyed, 68 (97.1 %) participated. Significantly fewer hospitals, specifically 13/68 (19.1 %), continued to routinely resuscitate neonates in 100 % FiO2. In 50/68 (73.5 %) hospitals all infants were resuscitated initially in room air. The remaining 5/68 (7.4 %) units resuscitated infants in 22–50 % FiO2 blended oxygen.

An oxygen blender was available in 47/68 (69.1 %) hospitals. Notably, oxygen blenders were not available in 12/13 (92.3 %) units that resuscitated initially in 100 % FiO2.

By 2012, full compliance with the Resuscitation Council (UK) guidelines had been achieved to 22/68 (32.4 %) hospitals, compared to 7/195 (3.6 %) in 2011.

Conclusions

A significant proportion of UK hospitals have changed their practices and implemented the Resuscitation Council 2011 (UK) guidelines. This survey shows it takes time to implement new routines and change human behaviours.

 

Whitby, TM; Whitby, V and Sinha, I. (2012).  Delivery room resuscitation in the UK: post-survey follow-up. Archives of Disease in Children Fetal and Neonatal Edition. Published online 5th September.

Whitby, T; Whitby, V; Sinha, I. (2013).  Delivery room resuscitation in the United Kingdom: Post survey follow-up. Intensive Care Medicine. 39 (Suppl 1), S35

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