Layouni I, Danan C, Durrmeyer X, Dassieu G, Azcona B, Decobert F
Arch Pediatr. 2011 Jul;18 Suppl 2:S72-8. doi: 10.1016/S0929-693X(11)71094-6.
An extreme attentiveness is mandatory when caring about extremely-low-gestational-age neonates at birth because of their innate vulnerability. The interventions performed during resuscitation of these infants may have direct influence on the immediate survival and also on long-term morbidity. Although stressfull, each resuscitation step is crucial and needs to be precise, fast and harmless. In order to determine our compliance to the international guidelines and to assess our neonatal performances in delivery room, we used a Mobotix camera to record all resuscitations of extremely-low-gestational-age neonates during the decisive first minutes of life. Neonatal medical and nursing staff agreed to be recorded. Our local ethics committee approved that videotaping neonatal resuscitation is an audit of clinical practice and thus does not require informed consent. During debriefing sessions, we reviewed the videotaped recordings, which allowed us to identify frequent deviations from the international guidelines and to re-educate and improve performance. The most frequent errors we recognized were errors of hygiene, not re-evaluating oxygen titration and airway obstruction during mask ventilation. We observed team behaviour and coordination during resuscitation and focused on quality of care. We believe that this method may be very effective as a teaching tool.
由于极低孕周新生儿天生脆弱，在其出生时护理时必须极度细心。对这些婴儿进行复苏期间所采取的干预措施可能会对其即刻存活以及长期发病率产生直接影响。尽管复苏过程充满压力，但每一个步骤都至关重要，需要精准、迅速且无害。为了确定我们对国际指南的遵循情况，并评估我们在产房的新生儿救治表现，我们使用了一台Mobotix摄像机记录极低孕周新生儿出生后关键的最初几分钟内的所有复苏过程。新生儿医护人员同意被录像。我们当地的伦理委员会批准，录像新生儿复苏属于临床实践审核，因此无需获得知情同意。在总结会议期间，我们查看了录像记录，这使我们能够识别出与国际指南的常见偏差，并进行再培训以提高救治表现。我们识别出的最常见错误是卫生方面的错误、未重新评估氧饱和度滴定以及面罩通气时的气道梗阻。我们观察了复苏过程中的团队行为与协作，并关注护理质量。我们认为这种方法作为一种教学工具可能非常有效。
