Infant simulator mimics neonatal emergencies

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WILMINGTON, Del. (AP) — Emergencies are so-called because it's hard to predict when they will happen.

That's certainly the case in the delivery room, where about 10 percent of all babies born need some kind of extra help transitioning to the world. Given that there are 4 million births a year, that's about 400,000 babies to think about. Of those, 1 percent need more extensive immediate care, such as a tube insertion to help with breathing, chest compressions or some other kind of medical intervention.

Nurses and delivery room staff are trained to handle these kind of scenarios, but it helps to have practice. That's the thinking behind the work done by the neonatal outreach education team from Christiana Care Health System. The team works with staff from local hospitals using a newborn simulator mannequin to help them anticipate and respond to emergency situations.

The mannequin, known as Newborn HAL, mimics a full-term baby at birth. The interactive simulator looks and sounds like the real thing, from the way it cries, its heart beats and even the way its skin coloring changes. It can be programmed to have the kind of problem a newborn might have at birth, such as an audible heart defect, breathing difficulties or requiring an IV insertion.

Staff can identify and treat these issues in advance of an actual emergency, so they are prepared if one arises. Nurses, respiratory therapists, pediatricians and even emergency department staff are among those who are trained using Newborn HAL's programmable emergencies.

"It is an awesome tool, as close to real life as you can get," said Dr. Wendy Sturtz, an attending neonatologist at Christiana Care, who is part of the training team. "We can run through different scenarios, so we'll present a scene, such as a baby who is born not breathing. They have to run through how they would handle that. Then we debrief them and teach them how the situation could have gone better."

Such simulations are beneficial because they give staff the chance to see the changes that occur in the newborn as they are implementing the interventions, said Jennifer Novack, a clinical specialist nurse at Milford Memorial Hospital, part of Bayhealth Medical Center.

"They can hear a baby cry. They can hear a lung sound," Novack said. "Nobody has to tell them that, like in a class with a doll that doesn't respond and they have to ask questions."

Sturtz said the NICU team has trained staff at Bayhealth Medical Center, Nanticoke Hospital in Seaford, Union Hospital in Elkton, Md., and Jennersville Regional Hospital in West Grove, Pa. These are among the hospitals that send critically ill newborns to Christiana Care's neonatal intensive care unit, which provides the highest level care in the state.

The portability of Newborn HAL is another asset because it encourages the hospital staff to look at ways they could change their own practices.

"It forces them to use supplies they have. They know in their own setting where necessary equipment is," Sturtz said.

Simulators like Newborn HAL are increasingly common at larger hospitals and universities as a training tool for staff. The University of Delaware not only uses HAL but also a laboring mother to help teach students in a safe, realistic setting, said Judith Herrman, a nursing professor at UD.

Even veteran nurses can get rattled by an unexpected emergency during birth. But knowing in advance what to do helps keep the focus on the patient, Novack said.

"Learning like this is a non-threatening way," she said. "You don't feel so stressed out. You know you're not going to hurt the baby. You can practice and go back and relearn."

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Information from: The News Journal of Wilmington, Del., http://www.delawareonline.com

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