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Title:
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Impact of a mobile application for heart rate assessment in simulated neonatal resuscitation: a randomised controlled cross-over study.
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Authors:
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Cavallin F; Independent Statistician, Solagna, Italy.
Binotti M; Division of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria 'Maggiore della Carità', Novara, Italy.
Ingrassia PL; Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie (SIMNOVA), University of Piemonte Orientale, Novara, Italy.
Genoni G; Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
Rizzollo S; Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
Monzani A; Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
Trevisanuto D; Dipartimento di Salute della Donna e del Bambino, Universita degli Studi di Padova, Padova, Italy.
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Source:
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Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2020 Jan; Vol. 105 (1), pp. 41-44. Date of Electronic Publication: 2019 May 17.
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Publication Type:
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Journal Article; Randomized Controlled Trial
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Language:
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English
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Imprint Name(s):
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Original Publication: London : British Medical Association,
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MeSH Terms:
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Mobile Applications*
Resuscitation*
Asphyxia Neonatorum/therapy ; Auscultation ; Bronchodilator Agents/administration & dosage ; Cardiopulmonary Resuscitation ; Communication ; Cross-Over Studies ; Epinephrine/administration & dosage ; Heart Rate ; Humans ; Infant, Newborn ; Intubation, Intratracheal ; Manikins ; Positive-Pressure Respiration
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Contributed Indexing:
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Keywords: NeoTapAS; heart rate; mobile application; neonatal resuscitation; timing
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Molecular Sequence:
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ClinicalTrials.gov NCT03730025
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Substance Nomenclature:
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0 (Bronchodilator Agents)
YKH834O4BH (Epinephrine)
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Entry Date(s):
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Date Created: 20190519 Date Completed: 20191223 Latest Revision: 20191223
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Update Code:
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20240104
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DOI:
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10.1136/archdischild-2018-316757
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PMID:
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31101662
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Background: Clinical assessment of newborn heart rate (HR) at birth has been reported to be inaccurate. NeoTapAdvancedSupport (NeoTapAS) is a free-of-charge mobile application that showed good accuracy in HR estimation. This study aimed to evaluate the impact of NeoTapAS on timing of HR communication and resuscitation interventions.
Methods: This was a randomised controlled cross-over (AB/BA) study evaluating HR assessment using auscultation plus NeoTapAS compared with auscultation plus mental computation in a high-fidelity simulated newborn resuscitation scenario. Twenty teams each including three paediatric residents were randomly assigned to AB or BA arms. The primary outcome was the timing of the first HR communication. Secondary outcomes included the timing of the following four HR communications and the timing of resuscitation interventions (positive pressure ventilation, chest compressions, intubation and administration of first dose of epinephrine).
Results: NeoTapAS reduced the time to the first HR communication (mean difference -13 s, 95% CI -23 to -4; p=0.009), and the time of initiation of chest compressions (mean difference -68 s, 95% CI -116 to -18; p=0.01) and administration of epinephrine (mean difference -76 s, 95% CI -115 to -37; p=0.0004) compared with mental computation.
Conclusions: In a neonatal resuscitation simulated scenario, NeoTapAS reduced the time to the first HR communication and the time of initiation of chest compressions and administration of epinephrine compared with mental computation. This app can be especially useful in settings with limited availability of monitoring equipment, but further studies in clinical scenarios are warranted.
Trial Registration Number: NCT03730025.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
