Neonatal Resuscitation

Our goal is to improve neonatal outcomes for babies born in the community, which is the only outcome currently in question with regards to homebirth. Dr. Lane has dedicated her doctoral work to addressing limitations in the neonatal resuscitation workshop that do not otherwise meet the needs of birth center-based or homebirth-based attendant. She has twenty years of experience working with neonates and ten years experience training midwives and their assistants in resuscitating the neonate.

Dr. Lane is an American Academy of Pediatrics NRP course instructor with two decade’s experience attending births, in the home, birth center and the hospital setting. She has developed a course that respects the midwifery-model-of-care, yet also equips the midwife and her assistants to confidently use the T-piece resuscitator and manage a full resuscitation complete through intubation, medication administration and umbilical line placement within the home environment. Neonatal outcomes appear to be the one outcome where hospital born babies favor the outcomes of those born at home. Failed resuscitative efforts have been identified as a significant variable.

Each neonate, whether born at home, or in the hospital, has a right to immediate and competent resuscitation.

Not a Lecture, but a Facilitated Discussion

Dr. Lane will offer a keynote presentation reviewing the homebirth literature and neonatal outcomes. The most current recommendation regarding neonatal resuscitation will be offered, as well as a plethora of information specific for the birth center-based and home birth-based provider, including delayed cord clamping, staffing models, and securing appropriate supplies and equipment. Clinical skills practice will also be emphasized including use of the T-piece resuscitator, self-inflating mask, compressed air and oxygen regulation, various suction options, and a plethora of intubation supplies and equipment. Administration of epinephrine will also be thoroughly discussed and techniques practiced.

All skills will be thoroughly reviewed and practiced until each attendant feels confident they can use the equipment effectively and efficiently. However, emphasis will be given to successfully navigating through homebirth resuscitative scenarios. Homebirth providers meet these scenarios so infrequently, mastering resuscitative skills can be a significant challenge. Repetition, being presented with a variety of scenarios, and debriefing offers a rich learning experience.

The 6th edition of the NRP text placed great emphasis on debriefing as part of the learner’s experience. Debriefing is not simply feedback from the instructor to the trainees; the goal is to discover what went well, what needs improved and how those improvements can be obtained. The best debriefings allow learners to link their simulation experiences to their personal, real-world experiences. It is important to understand that most of the learning does not take place during the scenarios, but rather the debriefing that follows.

Dr. Lane encourages midwifery practices to attend the course together, utilizing their own equipment and their own team members, to better apply the knowledge gained to their own real-world experiences. Neonatal resuscitation is most effective when performed by a designated  and coordinated team. It is important for you to know the neonatal resuscitation responsibilities of team members who are working with you. Periodic practice among team members will facilitate coordinated and effective care of the newborn.

The 7th edition of the NRP manual added two new lessons, preparing for resuscitation and post-resuscitative care. It continues to emphasize the importance of adequate preparation, but continues to ignore the needs of births in environments other than hospitals. This is where Dr. Lane works to meet those needs of birth center-based and homebirth-based attendants. Continued attention was given to adequate preparation, effective ventilation and teamwork. The details for troubleshooting and correcting ventilation issues have been expanded, as well as advanced skills such as cardiac monitoring. Intubation has also been given a higher priority and therefore, moved up in the order of lessons, prior to chest compressions. All attendants, no matter their role, are now responsible for attending the entire course because it is important that whomever is present for resuscitation is familiar with the needs of the neonate and how those will be performed, no matter how they are delegated.

Evidence is clear however, that successful completion of the written test has minimal predictive value for skills acquisition. NRP eSIM is a new online neonatal resuscitation simulation exercise required for achieving NRP provider status with the 7th edition. The eSIM methodology allows learners to integrate the NRP flow diagram steps in a virtual environment. It is Dr. Lane’s expectation that all learners participate in mock codes and debriefings.

Prior to Attendance

Course attendants are asked to read in its entirety the Textbook of Neonatal Resuscitation, 7th edition. The book can be ordered from the American Academy of Pediatrics website for $69.95. Believe Midwifery Services, LLC does not have books for loan to learners.

Homebirth attendants are not simply hired to attend uneventful births, and are not simply present to dial 911. We are the primary care provider for the mother and the neonate. Our responsibility is to provide a safe and satisfying experience. This course will demand a commitment to learning that role.

Bring to Class

Bring your textbook and your own neonatal stethoscope, as well as the completed experience survey (provided with confirmation of registration). Extra points are provided for those who bring snacks, appetizers or desserts.

Successful Completion of NRP

Successful completion of the online examination and eSIM cases is required prior to attending the skills and simulation portion of the NRP course. course. Learners must attend the skills and simulation portion of the course within 90 days of completing the online examination and eSim cases. To successfully complete the course, participants must pass the online examination, complete eSim cases, demonstrate mastery of resuscitation skills in the Integrated Skills Station, and participate in simulated resuscitation scenarios, as determined by Dr. Lane. Upon successful completion of these requirements, participants are eligible to receive a Course Completion Card. Following the skills/simulation portion of the course, learners will receive an e-mail with a link to complete an online course evaluation. Once the online course evaluation is completed, an electronic Course Completion Card will be available in the learner’s NRP Database profile.

Continuing Education Credit

The NRP online exam offers up to 9 CEUs. One credit hour is awarded for each lesson successfully completed. To obtain Continuing Education Credit, you must enter your license information in your HealthStream record. To enter this information click on the My Profile tab, click on Manage Discipline and License Information, click on Add Discipline/License and enter your information. If you did not enter  your license information before completing the exam, you may add this information later. To have the CE document you need appear, click on My Transcript, click on Neonatal Resuscitation Program Online Examination, 6th Edition, scroll to the bottom of the page and click Refresh Credits.

Upcoming NRP Workshops for the Homebirth & Birth Center-based Provider:

Course Fee

The workshop will offer hands-on experience throughout all the neonatal resuscitation skills for a course session fee of $300. 

All attendants will participate and test off in all lessons. The online test and purchase of the NRP text are additional fees paid directly to the American Academy of Pediatrics.

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