Evaluating time between birth to cry or bag and mask ventilation using mobile delivery room timers in India: the NICHD Global Network’s Helping Babies Breathe Trial

BMC Pediatrics

Linda L. Wright²  Norman Goco¹  Martha DeCain¹  Pablo Destefanis¹  Elizabeth M. McClure¹  Janet L. Moore¹  Amit P. Revankar³  Shivaprasad S. Goudar³  Manjunath S. Somannavar³ 

[1] RTI International, Durham, NC, USA;Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA;KLE University’s Jawaharlal Nehru Medical College, Belgaum, Karnataka, India

关键词: Helping babies breathe;    India;    Asphyxia;    Golden minute;    Resuscitation;   

Others  :  1223790
DOI  :  10.1186/s12887-015-0408-6

 received in 2015-01-06, accepted in 2015-07-15,  发布年份 2015

【 摘 要 】

Background

The Golden Minute®, the first minute following birth of a newborn, is a critical period for establishing ventilation after delivery, as emphasized in the Helping Babies Breathe® and other resuscitation training programs. Previous studies have reinforced training through observers’ evaluation of this time period; although observation is useful for research, it may not be a sustainable method to support resuscitation practice in low-resource settings where few birth attendants are available. In order to reinforce resuscitation within The Golden Minute®, we sought to develop a simple mobile delivery-room timer on an Android cell phone platform for birth attendants to use at the time of delivery.

Methods

We developed and evaluated a mobile delivery room timer to document the time interval from birth to the initiation of newborn crying/spontaneous respiration or bag and mask ventilation in a convenience sample of women who delivered in five hospitals in Karnataka, India. The mobile delivery room timer is an Android cell phone-based application that recorded key events including crowning, delivery, and crying/spontaneous respiration or bag and mask ventilation. The mobile delivery room timer recorded the birth attendant verbally indicating the time of crowning, birth-(defined as when the entire baby was delivered), crying/spontaneous respiration or bag and mask ventilation. The mobile delivery room timer results were validated in a subsample by a trained observer (nurse) who independently recorded the time between delivery and initiation of crying/spontaneous respiration or bag and mask ventilation.

Results

Of the total 4,597 deliveries, 2,107 (46 %) were timed; a sample (n = 438) of these deliveries was also observed by a trained nurse. There was high concordance between the mobile delivery room timer and observed time elapsed between birth and crying/spontaneous respiration or ventilation (correlation =0.94, p < 0.0001). The majority of neonates in both groups cried/breathed spontaneously or received bag and mask ventilation by 1 min (430/438 by the timer vs. 433/438 for observer).

Conclusions

We demonstrated that a simple mobile delivery room timer application was feasible to use during delivery and provided valid observations of the time to crying/spontaneous respiration or bag and mask ventilation. This type of tool may be useful in reinforcing neonatal resuscitation training and the need to ensure spontaneous or assisted ventilation by The Golden Minute®.

【 授权许可】

   
2015 Somannavar et al.

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