Resuscitation videos, and adherence to guidelines
A total of 90 newborns were resuscitated, of which 20 were judged to be
adequately recorded. The excluded cases were due to: 1) The camera was
shielded at the time of the resuscitation due to other patients in the
same room who did not provide their consent, 2) Consent was not obtained
before birth due to late presentation, labour pain, or an obstetrical
emergency, 3) The resuscitation was performed in another location. 4)
Technical camera issues. The remaining videos were analysed for quality
of care (table 4), and timelines for each resuscitation were created
(figure 2).
PPV initiation was inadequately performed in 15 cases (75%). The mean
time to first ventilation was 98 seconds (10 – 416 s). Timing was
started when the newborn was placed on the resuscitation table. Within
the first minute of life, nine patients (45%) were ventilated and 10
(50%) were not ventilated, and in 1 case (5.0%) no PPV was performed.
Suction was performed vigorously and repeatedly in 16 patients (80%),
and a median time of 65 seconds (12 – 177 s) was spent suctioning. In
all cases, ventilation was initiated but not sustained (or not performed
at all) with breaks between efforts. On average, in the first 15 minutes
or until resuscitation was ceased, no intervention was performed
one-third of the time.
Of the 20 resuscitation recordings, 10 (50%) died; eight after
attempting resuscitation (median time spent on resuscitation: 480
seconds (95 – 3632 seconds), and two died in the subsequent hours after
initially successful resuscitation.