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一分钟可能意味着一生

一个两个出生的故事:

以下是媒体广泛流传的真实故事。两者都涉及到孩子一生的第一时刻的紧急情况……

在第一个故事中,主持人进行了积极的培训,以识别和管理劳动力和分娩紧急情况。在诊断出存在的危险因素的即时性后,工作人员进行了精心计划和排练的努力,避免了对孩子的伤害。令家庭的喜悦,出生是巨大的成功。

在附近的设施中,发生了类似的紧急情况,但是另一个故事正在播放。如何诊断和解决情况导致紧急干预措施对孩子致命,并向母亲颁发了1,020万美元的奖励。

每年在全球范围内,估计有814,000例新生儿死亡与全学期婴儿中的产前缺氧事件(即“出生窒息”)有关。1在那些生存的人中,许多人遭受神经系统障碍。2

When a baby is born, he or she should begin breathing within the “Golden Minute,” their first 60 seconds outside of the womb. Most babies do begin breathing on their own. 10 million babies worldwide, however, will need assistance.3大约有10%的新生儿自行呼吸将对干燥,变暖,清除气道和刺激作出反应。而且,1%的非呼吸婴儿将需要先进的复苏方法,例如胸部压缩和药物。4

对家庭来说,1%的意思是一切。这1%的人妨碍了孩子的生存,即使他或她确实生存,也会增加脑部损伤的机会。相信她将获得最佳护理的母亲期望她的提供者为1%的风险做好了充分的准备。

One Minute: Too Short to Do Anything?

“金分钟”是指婴儿一生的前60秒。在这些有限的秒内,婴儿应开始对自己的呼吸,或者必须开始干预措施。

Approximately 4,000,000 babies are born each year in the United States.6据估计,这些婴儿中有400,000名将需要帮助呼吸和/或阳性通风才能成功过渡到外牙外寿命。而且,多达12,000名婴儿将需要采用胸部压缩和心脏药物的高级复苏。7

In each case,steps taken to treat an infant must be precise and timely

Nearly one half of newborn deaths occur during the first 24 hours after birth.8

围产期窒息和极端早产是两种妊娠并发症,需要复杂的复苏。但是,只能预测60%的窒息新生儿。9剩下的新生儿直到“黄金分钟”才被确定,这就是为什么准备要做的事情。

为什么新生儿复苏程序®(NRP®)很重要

由于出生时经常需要复苏,因此制定基于证据的护理指南并培训有效的新生儿复苏至关重要。

确保卫生保健提供者保持直到date on advances in neonatal resuscitation, the American Heart Association (AHA) and American Academy of Pediatrics (AAP) jointly develop neonatal treatment guidelines for the United States. The Neonatal Resuscitation Program® (NRP®), which is developed by the American Academy of Pediatrics, translates theAAP/AHA Guidelines for Emergency Cardiovascular Care and Resuscitation of the Neonateinto an educational curriculum.

AAP开发的课程包括:ESIM,技能练习,在线考试以及模拟/汇报。混合学习方法有助于准备医疗保健专业人员以促进effective team-based care

Anticipation, adequate preparation, accurate evaluation, and prompt initiation of support are critical for successful neonatal
复苏。10

新生儿复苏失败的一些最常见原因包括:11

  • Failure to detect the need for resuscitation shortly after birth
  • Failure to have a qualified, experienced medical professional close by after a birth with heightened risk factors
  • Breakdowns in teamwork and communication
  • 新生儿复苏技术不当

NRP课程有助于提高护理团队的信心,并提高每个成员的复苏和稳定技能。此外,该课程专门解决了沟通和决策过程,这些过程是新生儿一生中首先(也是最重要的60秒)所必需的。

重现出生奇迹

Simulation plays a vital role in learning NRP. Simulation reinforces skills and knowledge integration; but, more importantly, it introduces human factors and a focus on patient safety into the scenario.

团队沟通,与父母的互动以及新生儿遇到困扰时不可避免的不安的感觉都可以在模拟过程中重新创建,从而在面对重症新生儿时降低压力水平。

模拟培训还有助于预防医疗错误。模拟培训通过连续的系统培训,绩效评估和团队实践的完善来解决可预防的错误。13

一项研究发现,在实际临床环境中进行的原位模拟训练有助于显着减少新生儿复苏期间的危险事件数量。14Another study found that nurses were almost 40% more likely to challenge an incorrect dosage of epinephrine following simulation training.15

Following simulation training, care providers are likely to see an improvement in clinical decision-making, sharpened skills, and increased self-confidence all of which are critical during neonatal resuscitation.

A Happy Beginning

一个熟练,自信和凝聚力的护理团队可以在婴儿一生的第一分钟内改变一切。通过新生儿复苏培训,医疗保健专业人员可以更好地识别出遇险的新生儿,并在60秒内开始治疗。

One minute can determine a life and a lifetime.

为了遵循我们帮助挽救生命的使命,Laerdal致力于帮助您提供培训,以便可以使从业者为管理这一刻的每一秒钟做好准备。我们希望帮助您确保直接或间接接触的每个分娩都是一个快乐的开始。

参考

  1. Imdad, A., Yakoob, M.Y., Siddiqui, S., & Bhutta, Z.A. (2011). Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: A systematic review with a focus on reduction of IUGR related stillbirths.BMC Public Health, 11(3)。DOI:https://doi.org/10.1186/1471-2458-11-S3-S1
  2. My Child. (2017).低氧缺血性脑病或HIE,也称为窒息。从...获得:http://www.cerebralpalsy.org/about-cerebral-palsy/cause/hypoxic-ischemic-chemic-脑病
  3. Heerden,V。(2012)。帮助婴儿呼吸的介绍:黄金分钟在南非新生婴儿。今天的专业护理,16岁(3)。
  4. Ibid
  5. 美国心脏协会。(2005)。新生儿复苏指南。American Heart Association, 112(24). DOI:https://doi.org/10.1161/circulationaha.105.166574
  6. Ibid
  7. Ibid
  8. Bissinger, R.L. (2015). Neonatal resuscitation. Medscape. Retrieved from:https://emedicine.medscape.com/article/977002-Overview
  9. Ibid
  10. 美国心脏协会。(2005)。See reference #4.
  11. 出生伤害指南。(2017)。婴儿复苏错误。出生伤害指南。从...获得:http://www.birthinjuryguide.org/birth-injury/causes/infant-resuscitation-errors/
  12. Stokowski, L.A. (2006).Simulation training in neonatal resuscitation: Practice makes perfect。Medscape。从...获得:https://www.medscape.com/viewarticle/541371
  13. Ibid
  14. Rubio-Gurung, S., Putet, G., Touzet, S., Gauthier-Moulinier, H., Jordan, I., Beissel, A., et al. (2014). In situ simulation training for neonatal resuscitation: An RCT.Pediatrics, 134(3), 790-797. DOI: 10.1542/peds.2013-3988
  15. Sawyer, T., Laubach, V., Yamamura, K., Hudak, J., Pocrnich, A. (2013).Interprofessional teamwork training in neonatal resuscitation using TeamSTEPPS and event-based approach simulation。Association of American Medical Colleges. Retrieved from:https://www.mededportal.org/publication/9583/#274981
  16. Halamek, L.P., Kaeji, D.M., Gaba, D.M., Sowb, Y.A., Smith, B.C., Smith, B.E., et al. (2000). Time for a new paradigm in pediatric medical education: Teaching neonatal resuscitation in a simulated delivery room environment.Pediatrics, 106(45)。
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