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CSCSTANDARDIZEDCURRICULUMSPECIALTYPEDIATRICSSIMULATIONNEONATALRESUSCITATIONSUBMITTEDBYMAJTAYLORSAWYERTARGETAUDIENCEPEDIATRIC,FAMILYMEDICINE,OBSTETRIC/GYNECOLOGYRESIDENTSANDPEDIATRIC,FAMILYMEDICINE,OBSTETRIC/GYNECOLOGYMEDICINESTAFFACGMECOMPETENCIESADDRESSEDPATIENTCAREMEDICALKNOWLEDGEPRACTICEBASEDLEARNINGDONOTMAKEASSUMPTIONSDONOTDECLARETHEANSWERS/RESULTSTOPHYSICALFINDING/LABSWITHOUTASKING5ASSUMETHATYOUCANREQUESTANYRESOURCEYOUWOULDHAVEAVAILABLEINTHEHOSPITALINWHICHYOUARETRAININGSIMULATIONSETUPSIMULATORSTOBEUSEDGAUMARDPEDIBLUENEONATALSIMULATORSIMULATIONLOCATIONLABORANDDELIVERYROOMFORPRIMARYSCENARIOOPERATINGROOMFORALTERNATESCENARIOROOMSETUPTHELABORANDDELIVERYROOMORORSHOULDBESETUPINTHESTANDARDFASHIONWITHMOTHERSBEDANDINFANTWARMERTHEGAUMARDNOELLEMATERNALSIMULATORCANBEPLACEDINTHEBEDANDCONFEDERATESACTINGASOBSTETRICIANSCANBEDRESSEDGOWNSANDGLOVESSIMULATINGTHEDELIVERYTHEINFANTSIMULATORSHOULDBEDELIVEREDTOTHEWARMERBYOBSTETRICIANASINAREALDELIVERYTHEROOMSHOULDBESTOCKEDWITHTHEUSUALINSTRUMENTSBAGVALVEMASK,LARYNGOSCOPE,ETTUBES,BULDSUCTION,DELEESUCTION,ETCANDMEDICATIONSEPINEPHRINE110,000,42SODIUMBICARBONATE,NORMALSALINE,ETCUSEDINADELIVERY/RESUSCITATIONADDITIONALEQUIPMENTNEEDEDBIRTHINGSIMULATORGAUMARDNOELLEMATERNALSIMULATORINFANTWARMERSTANDARDNEONATALRESUSCITATIONEQUIPMENTINCLUDINGBULBSUCTIONBAGVALVEMASKLARYNGOSCOPEETTUBES2540STYLETDELEESUCTIONCATHETERANDTUBINGUMBILICALLINEKITUMBILICALCATHETERSYRINGESMEDICATIONSEPINEPHRINE,BICARBONATE,NORMALSALINEOPTIONALEQUIPMENTFETALMONITORINGGAUMARDNOELLEMATERNALSIMULATORINCLUDESAFETALMONITORTHATMAYBEUSEDINTHEPRIMARYSCENARIOTOPRODUCEFETALBRADYCARDIAPERSONNELNEEDEDGAUMARDPEDIBLUETECHNICIANTOOPERATECONTROLSANDUMBILICALPULSECONFEDERATESTOACTASOBSTETRICIANSANDORPERSONNEL23BEDSIDENURSE1SCENARIOSUPERVISOR1SCENARIOGRADER1BASICSCENARIOTIPSPARTICIPANTSSHOULDBEPAGEDSTATONTHEREGULARDELIVERYPAGERSTOTHEDRORORYOUAREUSINGFORSIMULATIONUPONARRIVALTHERESIDENTSSHOULDBEGIVENABRIEFHISTORYBYONEOFTHECONFEDERATEOBSTETRICIANGIVETHEPARTICIPANTS60SECONDSTOSETUPTHEWARMERANDEQUIPMENTPRIORTODELIVERINGTHEBABYWHENTHEINFANTISDELIVEREDITSHOULDBEWALKEDBYTHECONFEDERATEOBSTETRICIANANDPLACEDONTHEWARMERONCEONTHEWARMERTHEPEDIBLUETECHNICIANWILLNEEDTOOPERATETHECONTROLSFORHR,ANDCYANOSISUMBILICALPULSEWILLNEEDTOBESIMULATEDUSINGTHEHANDPUMPFORTHISMANIKINCASEFLOW/ALGORITHMWITHBRANCHPOINTANDCOMPLETIONCRITERIAINITIALSTATEBOTHSCENARIOSAPPERANCECENTRALCYANOSISBLUELIGHTSONBOTHFACEANDHANDWITHPEDIBLUEPULSE30SELECTEDONPEDIBLUECONTROLANDSIMULATEDWITHHANDPUMPGRIMACENONEACTIVITY/TONELIMPRESPIRATIONSABSENTINBOTHSCENARIOSTHEINFANTISBORNBASICALLYLIFELESS,EXCEPTASLOWPULSEPARTICIPANTSMUSTPROCEEDTHROUGHTHECOMPLETENRPRESUSCITATIONALGORITHMSEEBRIEFDIDACTICFORREVIEWINCLUDINGTHEPLACEMENTOFANEMERGENCYUMBILICALVEINCATHETERORIOLINEFORTHEVERYINTREPIDANDADMINISTRATIONOFIVEPINEPHRINEBEFORECLINICALSTATUSIMPROVESHRINCREASESTO150,CENTRALCYANOSISRESOLVESENDOTRACHEALEPIADMINISTRATIONDOESNOTCHANGESCENARIOCASEFLOW/ALGORITHMIFGIVENIFGIVENINITIALSTATEHR30NORESPIRATORYEFFORTLIMPCYANOTICDRYANDSTIMULATEINFANTNOCHANGEBAG/MASKVENTILATIONNOCHANGEINTUBATIONNOCHANGEENDOTRACHEALEPINOCHANGEEPIGIVENVIAUMBILICALVESSELCATHETERNOCHANGENOCHANGENSBOLUSGIVENVIAUMBILICALVESSELCATHETERHRTO150CENTRALCYANOSISRESOLVESNOCHANGENOCHANGENOCHANGENOCHANGECHESTCOMPRESSIONSNOCHANGENOCHANGEBICARBONATEVIAUMBILICALVESSELCATHETERNOCHANGENOCHANGENOCHANGECRITICALACTIONS1MUSTWARM,DRYANDSTIMULATEINFANT2MUSTREPOSITIONAIRWAY3MUSTPROVIDEATLEAST30SECONDSEFFECTIVEPOSITIVEPRESSUREVENTILATIONBEFOREMOVINGTOCHESTCOMPRESSIONS,INTUBATION,LINEPLACEMENT,DRUGS,ETC4060BREATHS/MIN4MUSTUSE100FIO2DURINGTHERESUSCITATION5MUSTPROVIDEPOSITIVEPRESSUREVIABVMWITHGOODHANDPOSITIONANDSEALOFMASKONFACE6MUSTCHECKFORHRANDCOMMUNICATERATETOCODELEADER7MUSTGIVECOMPRESSIONSONCEHRIS400040140910ETSIZEEQUALTOGESTAGE25WKS25TUBE,30WKS30TUBE,35WK35TUBE,ETCETDEPTH6CMWEIGHTINKG1KG7CMATLIP,2KG8CMATLIP,3KG9CMATLIP,ETCNRPMEDICATIONSMEDICATIONSDOSE/ROUTECONCENTRATIONWTKGIVVOLUMEMLPRECAUTIONSEPINEPHRINEIVUVCPREFERREDIV0103ML/KGHIGHERIVDOSESNOTRECOMMENDEDET031ML/KG110,00012340103020603090412GIVERAPIDLYFOLLOWEDBYNSFLUSHREPEATQ35MINHIGHERDOSEFORETROUTEVOLUMEEXPANDERS10ML/KGIV123410203040INDICATEDFORHYPOVOLEMICSHOCKCORDACCIDENT,ABRUPTION,ETCGIVEOVER510MINUTESREASSESSAFTERBOLUSSODIUMBICARB12MEQ/KGIV05MEQ/ML42SOLUTION12342448612816ESTABLISHADEQUATEVENTILATIONFIRSTONLYFORPROLONGEDNRPSLOWPUSHOVER2MINNALOXONE01MG/KGIVORIMPREFERREDROUTEETROUTENOTRECOMMENDEDNEONATALVIAL04MG/ML12340250500751ADDRESSVENTILATIONFIRSTWITHROUTINEMEASURESPPVREPEATQ23MINCAUTIONINOPIOIDADDICTIONCANADULTVIAL1MG/ML123401020304CAUSESEIZUREDEXTROSE10SOLUTION2ML/KG,D10WIV01G/ML12342468CHECKBEDSIDEGLUCOSEPOSITIVEPRESSUREVENTILATIONINDICATIONSPOSITIVEPRESSUREVENTILATIONWITHTHEBAGVALVEMASKISTHEMOSTCRITICALSKILLTOLEARNINNRPPPVSHOULDBEPROVIDEDTOALLINFANTSWHODONOTESTABLISHGOODRESPIRATORYEFFORTAFTER30SECONDSOFWARMINGANDSTIMULATIONTHEPROVISIONOFEFFECTIVEPPVVIABVMWILLRESOLVESECONDARYAPNEAANDRESULTINIMPROVEMENTINHRANDRESPIRATORYEFFORTINTHEVASTMAJORITYOFDEPRESSEDNEONATESREVIEWWITHPARTICIPANTSTHECORRECTMASKFITANDPO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