Abstract 77

Current European neonatal resuscitation guidelines advocate cardiopulmonary resuscitation (CPR) at a compression rate of 120 per minute & a ratio of 3 compressions: 1 breath. We aimed to assess the ability of medical & nursing staff to fulfill these criteria using a simulated arrest scenario.

Anaesthetists, paediatricians, midwives & neonatal nurses were asked to perform CPR, following European guidelines, for 5 minutes on a Resusci-baby®(Laerdal), either singly (n=33) or in pairs (n=33).

Measurements of the number of breaths & compressions delivered were made by inductance plethysmography using 2 respibands connected to a computer programme used in our hospital for infant sleep studies. Outcome measures used were the number of breaths delivered in the 1st & 5th minutes of the scenario.

Of 33 single resuscitators, none were able to deliver 40 breaths/minute in either the 1st minute (range 11-34 [mean 20.69. SD ± 6.69]) or the 5th(13-35 [20.87 ± 6.57]). Of 12 paired rescuers. 4 achieved 40 breaths/minute in the 1st minute (24-45 [35.17 ± 7.02]) & only 2 sustained this to the 5th minute (21-48 [35.7 ± 8.14]). 2 pairs were not even able to complete 5 minutes of resuscitation.

In this study single rescuers were not able to achieve the CPR standard suggested by current neonatal resuscitation guidelines. This is mainly due to the logistics of performing 3 compressions & a breath every 1.5 seconds. Our results suggest that 2 rescuers may be able to provide this rate of CPR but are unlikely to be able to maintain it for 5 minutes. Based on these findings we recommend that consideration should be given to modifying the guidelines to make them practicable.