Nurse-led newborn resuscitation in an urban neonatal unit
Version of Record online: 27 AUG 2008
©2008 The Author(s)/Journal Compilation ©2008 Foundation Acta Pædiatrica/Acta Pædiatrica
Volume 97, Issue 12, pages 1620–1624, December 2008
How to Cite
Neal, D., Stewart, D. and Grant, C. C. (2008), Nurse-led newborn resuscitation in an urban neonatal unit. Acta Paediatrica, 97: 1620–1624. doi: 10.1111/j.1651-2227.2008.01000.x
- Issue online: 6 NOV 2008
- Version of Record online: 27 AUG 2008
- Received 7 March 2008; revised 13 July 2008; accepted 25 July 2008.
- Clinical competence;
- Nurse's role;
- *Resuscitation/mt [Methods]
Aim: To determine the safety and efficacy of neonatal nurses attending at-risk deliveries.
Methods: An audit of 2 years of delivery attendance by neonatal nurses at an urban hospital. Attendance also by a paediatrician if expected birth weight <2 kg, gestation < 35 weeks, twin pregnancy, foetal distress or any anomaly anticipated to seriously affect the newborn's health.
Results: About 3021 deliveries were attended, 2228 (74%) by a neonatal nurse, 776 (25%) by a neonatal nurse and a paediatrician and 17 (1%) by a paediatrician. Twenty-three children required intermittent positive pressure ventilation via endotracheal tube and/or cardiac massage. All but five of these were deliveries where both a neonatal nurse and a paediatrician were present. Three of these five deliveries had foetal tachycardia.
There were 33 deliveries managed by the neonatal nurse alone where the 1-min Apgar was three or less. All achieved a 10-min Apgar of seven or greater. Over the study interval, the proportion of deliveries attended only by a neonatal nurse increased and intensity of resuscitation administered decreased.
Conclusion: Appropriately trained neonatal nurses can safely resuscitate newborns. Addition of foetal tachycardia to the indications for paediatrician attendance identifies infants likely to require more resuscitation.