Resuscitation

Goal: Provide residents with capable skills and knowledge to perform and supervise a complete neonatal resuscitation.

Objectives:

1. Give knowledge of the pathophysiology of asphyxia.
2. Provide skills in procedures required for resuscitation and meconium suctioning.
3. Provide clinical situations to use the thinking process and the steps of resuscitation.
4. Give knowledge of the role of a pediatrician in resuscitation.
5. Give knowledge of the consequences of inappropriate resuscitation.
6. Train residents in the team concept.

Resident experience in neonatal resuscitation in the delivery room occurs at the MHC (the Level III regional transport center) where there are 4,000 deliveries per year including over 250 high-risk maternal transports. Residents attend all high-risk deliveries, primary cesarean sections, and problem deliveries (e.g. meconium, fetal distress) with the neonatal team consisting of neonatal nurse, respiratory therapist, and at least one of the following: PL-2, Neonatal Fellow, or attending Neonatologist. There are ample cases to learn all aspects of resuscitation including all procedures.

All procedures are supervised and a resident does not work independently until the attending is assured of his/her satisfactory performance. Manikins are available to enhance procedure skills. A lecture and video on neonatal resuscitation and its consequences are part of the NICU rotation. Residents also partake in the PALS course with neonatal emphasis. Formal neonatal resuscitation courses are offered periodically throughout the year. Lectures on asphyxia and meconium aspiration are provided. All PL-2's are expected to work independently once the knowledge and skills are satisfactorily acquired.