(43) Positive Pressure Ventilation of the Newborn: A Needs Assessment to Inform Development of a Simulation-based Curriculum for Emergency Medicine Interns

Priya V. Creed, Indiana University, Indianapolis, IN, United States; Sara Kane, Indiana University, United States

Background: The American College of Emergency Physicians along with the American Academy of Pediatrics and the Emergency Nurses Association published a joint policy statement in 2009 that states emergency departments should be ready to care for all children from neonates to adolescents. However, a precipitous delivery during prehospital transport or in the emergency department is a rare event. Many agree that establishing effective ventilation is the most critical step in a newborn that requires resuscitation. Due to infrequent experience, emergency medicine (EM) physicians may not know the indications for positive-pressure ventilation or how to troubleshoot this critical aspect of the resuscitation.

Objectives: To conduct a needs assessment with EM faculty and residents to understand their attitudes and skills with newborn resuscitation, particularly positive-pressure ventilation.

Design/Methods: A review of published literature was conducted to assess the current training that EM residents receive in neonatal resuscitation. A targeted needs assessment was then conducted at our institution using a fourteen-question electronic survey which was sent to EM faculty and residents.

Results: Only one study evaluated EM residents’ newborn resuscitation skills and knowledge, and it showed an opportunity for improvement. Our targeted needs assessment had a total of 51 respondents which includes 31 faculty (61%) and 20 resident (39%) responses (Figure 1). The majority of respondents “agree” or “somewhat agree” that neonatal resuscitation was a valuable part of EM training (98%), wanted more training in the area (82%), and believed a standardized curriculum was needed (73%). 73% were “very confident” or “somewhat confident” in knowing the indications for positive-pressure ventilation but only 45% knew how to troubleshoot positive-pressure ventilation (Figure 2).

Conclusion: Our survey suggests that faculty and trainees regard newborn resuscitation as an important part of EM and would like more standardized training in this area. Although most knew the indications for starting positive-pressure ventilation, there was less confidence when it came to knowing how to troubleshoot this core skill crucial to neonatal resuscitation. Since EM physicians rarely perform neonatal resuscitation, it further emphasizes the need for a standardized curriculum in this aspect of training to prepare them for such a clinical encounter. Using Kern’s Six Step Approach to Curriculum Development, a simulation-based curriculum for EM interns was developed based on results from this survey and will be piloted in July 2022 with incoming EM interns.