O3286: Development of a Novel Training Course for Emergency Medical Service Providers in Newborn Resuscitation and Transport- easy as 1, 2, 3

Background: The number of infants born out of the hospital, known as “field deliveries,” are increasing across the US. If the infant is unstable, parents rely on emergency medical services to resuscitate, stabilize, and transport their child to the hospital. These calls are a low incidence but high risk call for EMS providers. However, EMS providers are not required to be current on Neonatal Resuscitation Program training. Many do not feel confident in their skills and training for emergency newborn transports. This leads to infants suffering from preventable complications due to providers having
inadequate experience in newborn resuscitation. Training in Newborn Resuscitation and Transport (NRT) can address that gap.

Methods: Over the past two years, a multidisciplinary course focused on the resuscitation, stabilization and transport of the field delivered baby was developed- the ABCs of NRT-easy as 1, 2, 3- as a one day course that includes a brief lecture discussing the ABCs of NRT followed by skill stations and simulated cases with structured debriefing. The course has been presented to 116 Advanced-Emergency Medical Technicians (A-EMTs) from eight local EMS agencies. They were trained in newborn resuscitation, including how to administer PPV, place an advanced airway, give chest compressions, achieve IV or I/O access, and dose epinephrine, treat hypoglycemia, and prevent hypothermia. For the last 81 students, a pre course and post course survey was administered that focused on the confidence that the EMS providers felt using a Likert scale ranging from 1 little or no experience to 5 level of expert in the following areas;
Performing initial steps of resuscitation
Providing PPV with corrective steps
Endotracheal intubation
Placement of laryngeal mask
Providing chest compressions.
The results were analyzed using traditional comparative statistics- paired t test.

Results: Eighty one of the 116 students filled out the survey. Paired t tests of the responses showed improved confidence in all areas that were statistically significant.
Performing initial steps of resuscitation Pre- 2.99 Post- 3.86 p <.001
Providing PPV with corrective steps 2.83 3.90 p<.001
Endotracheal intubation 2.10 3.37 p<.001
Placement of laryngeal mask 2.56 3.60 p<.001
Providing chest compressions. 3.40 4.07 p<.001
All of these results indicate that the EMS providers felt more confidence in providing these critical skills after the course.

Conclusion: The ABCs of NRT – Easy as 1, 2, 3 is proven to increase the confidence of EMS providers in newborn resuscitation and transport. When empowering EMS providers with the specific knowledge of NRT with opportunity to practice clinical skills, they are more likely to provide appropriate care to field-delivered infants during transport to the hospital. This course focused on the importance of providing PPV, placement of advanced airways, appropriate chest compressions and medication administration that are unique to the newborn.