Hands on Workshop: Complex Resuscitations in Neonates and Infants - Managing High Acuity, Low Occurrence (HALO) Events

Sunday, May 5, 2024

8:00 AM – 9:30 AM ET

Location: Metro Toronto Convention Centre: 717 A

CE: Live CME: 1.5

Leader(s)

Lindsay Gilmore, MD (she/her/hers)

Neonatal-Perinatal Fellow
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania, United States

Slides

Co-Leader(s)

Mark Castera, MD (he/him/his)

Neonatal-Perinatal Medicine Fellow
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Michelle Bartlett, MD, MS (she/her/hers)

Fellow
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Elizabeth Wetzel, MD, MS (she/her/hers)

Assistant Professor of Clinical Pediatrics
Pediatrics
Riley Hospital for Children at Indiana University Health
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana, United States
Suma Hoffman, MD, MS (she/her/hers)

Associate Professor of Pediatrics
Pediatrics
Children's National Health System
Washington, District of Columbia, United States
SS

Simranjeet Sran, MD, MEd, CHSE, FAAP (he/him/his)

Director of Education, Simulation Program
Children's National Hospital
Washington, District of Columbia, United States
Lamia Soghier, MD, MEd, MBA

Professor of Pediatrics
George Washington University School of Medicine and Health Sciences
Fairfax Station, Virginia, United States
RG

Ruby Gupta, MD MS (she/her/hers)

Associate Professor
Pediatrics
Medical College of Wisconsin
MCW
Milwaukee, Wisconsin, United States
Morgan Hill, MD (she/her/hers)

Assistant Professor of Pediatrics, Division of Neonatology
Cincinnati Children's Hospital Medical Center
Loveland, Ohio, United States
Rita Dadiz, DO (she/her/hers)

Professor of Pediatrics
University of Rochester Medical Center
Rochester, New York, United States
Kesi Yang, MD (she/her/hers)

Assistant Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Wallingford, Pennsylvania, United States

Disclosure(s):

Lindsay E. Gilmore, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Mark R. Castera, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Michelle J. Bartlett, MD, MS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Elizabeth Wetzel, MD, MS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Suma B. Hoffman, MD, MS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Simranjeet S. Sran, ME, MEd, CHSE, FAAP: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Lamia Soghier, MD, MEd, MBA: American Academy of Pediatrics (Ongoing) (Products/Services: Intellectual Property including patent beneficiary and royalties); Etiometry (Ongoing) (Products/Services: Research Support including clinical trials & the principal or named investigator); Pyrames (Ongoing) (Products/Services: Research Support including clinical trials & the principal or named investigator)

Ruby Gupta, MD MS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Morgan E. Hill, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Rita Dadiz, DO: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Kesi Yang, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Workshop

Description: Successful management of High Acuity, Low Occurrence (HALO) events requires specific cognitive, technical, and behavioral skills. The Neonatal Resuscitation Program (NRP) provides a framework that addresses these skills in the context of the delivery room. However, this framework and associated skills may not be applicable to the complex and heterogeneous population of infants admitted to the NICU. Anticipating, preparing for, and responding to a wide variety of complex resuscitation scenarios (HALO events) is challenging but required given the risk of mortality. Challenges include limitations of current resuscitation guidelines (NRP vs PALS), lack of comfort with non-delivery room resuscitations, significant cognitive load during HALO events, and lack of appropriate cognitive aids. Many of these challenges can be addressed with targeted, technology-enhanced simulation training, which has consistently been associated with improvements in knowledge, technical skills, and behaviors. Simulation can be utilized to make HALO events more familiar, thus improving provider performance and patient outcomes. Simulation allows providers a platform to practice rare procedures, integrate cognitive aids, and utilize novel resuscitation roles and technologies. Additionally, simulation provides a safe space to critically evaluate resuscitation skills through structured debriefing. The use of simulation is a necessity in the increasingly complex world of neonatal and infant resuscitation and should be utilized to improve resuscitation practices.

Learning Objectives:

Demonstrate successful “hands-on” management of complex resuscitations and skills for high acuity, low frequency events in the NICU.
Demonstrate adjunctive use of technologies in complex resuscitations.
Discuss ways to improve responses to resuscitation events at your institution including use of cognitive aids, CPR coaches, and simulation/debriefs.