G199(P) Comparing the acccuracy of delivery of a sustained inflation to inflation breaths on a neonatal mannequin

Aims The Neonatal Life Support (NLS) guidelines currently recommend delivery of five inflation breaths (IB) each lasting two to three seconds.1 In practise, however, doctors often fail to deliver the recommended duration.2 There has been increasing interest in delivery of a sustained inflation (SI=15 s) as initial resuscitation of prematurely-born infants. Our aim was to investigate how accurately neonatal doctors could deliver an SI compared to IB using a resuscitation mannequin. Methods Doctors were invited to deliver five IB (each five seconds in duration) and a fifteen second SI to a neonatal mannequin. A respiratory function monitor was used to assess the duration of the inflations. Recordings were made after the doctors had the opportunity to practise using the equipment and delivering an SI. All were trained in NLS. Results Twenty four doctors took part in the study. The median error for IB was −0.8 s, that is, on average, each inflation was 0.8 s too short and for SI the median error was +0.34 s, that is, on average, each inflation was 0.34 s too long. The magnitude of error was significantly higher for IB than SI (26% versus 5.7% respectively, p=0.001). To further compare the variability in the two techniques the IB results were divided by three and the SI results by 15. The interquartile range for IB was 0.59 s and for SI was 0.25 s, demonstrating much closer clustering of results around the median for the SIs (Table 1). Conclusions A fifteen second SI was delivered more accurately than three second inflation breaths by neonatal doctors using a mannequin. Studies of neonatal resuscitation should examine the accuracy with which the techniques are applied. References . (UK) RC. NLS Guidelines (Resuscitation Council). resus.org.uk . Murthy V, et al. Eur J Pediatr2012;171:843–6.