Associate Professor Oregon Health & Science University School of Medicine Portland, Oregon, United States
Background: Out-of-hospital births are associated with a 2 to 11-fold increased risk of death compared to in-hospital births. EMS personnel have limited exposure to manage out-of-hospital birth emergencies. Our prior research found deficiencies in the critical steps of warming, drying, and initiating bag-mask ventilation (BMV) for a newborn in distress. There is no standardized neonatal resuscitation curriculum for medical providers outside of the hospital setting. Neonatal Resuscitation Program(NRP) guidelines are the standard of care for infants born in the United States and specific for in-hospital births. Operational differences between hospital-based teams and EMS render the NRP program, as currently taught, poorly suited to EMS needs. Objective: To develop, pilot test, and refine a neonatal resuscitation curriculum for EMS Design/Methods: We developed an interactive, EMS-tailored, NRP-based educational curriculum focusing on the initial steps of newborn resuscitation in the out-of-hospital setting. The curriculum was pilot-tested among 350 EMS providers during a 3-day virtual EMS Multi-Agency training event. The curriculum was refined and finalized based on feedback from pilot testing, including input from EMS medical directors and EMS educators. The virtual curriculum is approximately 60 minutes long and consists of an NRP-based didactic covering elements of the NRP algorithm suitable for EMS-treated births with memory aids. Teaching points are reinforced with videos demonstrating the actions. Lastly, there are prompts for hands-on skills stations to reinforce muscle memory for the skills learned, focusing on critical initial steps of warm, dry, stimulate and ventilation. Results: Eighty-nine percent (313/350) of participants responded to the curriculum assessment survey. Eighty-three percent highly recommended the training to other EMS agencies, 91% reported they would change their clinical practice based on the training, and 76% found the course valuable relative to other EMS education offerings. The virtual format provided a means to train “a lot of people” and allow for “speed and efficiency” in getting through the content.
Conclusion(s): This EMS-tailored virtual curriculum was highly rated by EMS personnel. It provides content that is relevant to all levels of EMS training, is practical, and it is free. The virtual approach provides flexibility for EMS agencies and offers the potential for just-in-time update trainings. Our future goal is to extend availability nationwide to improve access to EMS-specific NRP training.
