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A Survey of Academic Neonatologists on Neonatal Electrical Cardioversion and DefibrillationFunding There was no funding for this project.
Objective This study aimed to assess neonatologists' experience and comfort with neonatal electrical cardioversion or defibrillation (EC-D).
Study Design Electronic surveys were distributed to academic neonatologists affiliated with 12 Midwest academic hospitals. Neonatologists were asked about their residency training; years since completing residency; current certification/competency training in the Basic Life Support (BLS), Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support (ACLS), and Neonatal Resuscitation Program (NRP); experiences with EC-D; availability of a pediatric cardiologist; and their comfort levels with such procedures. Standard statistical tests evaluated comfort with EC-D.
Results Seventy-two out of 180 neonatologists responded to the survey (response rate = 40%). Of them, 98.6% (71), 54.2% (39), and 37.5% (27) maintained current NRP, BLS, and PALS trainings, respectively. Also, 73.6% (n = 53) reported having performed neonatal EC-D. Of those, 50.9% (n = 27) indicated feeling slightly to very uncomfortable performing EC-D. We report a lack of BLS certification being associated with a lack of comfort (odds ratio [OR]: 0.269, 95% confidence interval [CI]: [0.071, 0.936]), and a positive association between a pediatric cardiologist being present and being uncomfortable (OR: 3.722, 95% CI: [1.069, 14.059]). Those reporting greater volume and more recent experience with EC-D report more comfort.
Conclusion Of neonatologists who performed EC-D, half of them reported being uncomfortable. BLS certification and experience are positively associated with comfort in performing EC-D. Simulations to increase training in EC-D should be offered regularly to academic neonatologists.
Most neonatologists have performed EC-D, but many feel uncomfortable with performing EC-D.
Many do not maintain current certification in BLS, PALS, or ACLS.
Simulation training in EC-D will increase comfort with EC-D.
Authors have no financial disclosures to report related to this study.
C.P. designed the study and helped to write the manuscript. C.R. prepared the manuscript. P.C.D. helped to edit the manuscript. A.O. helped with the design of the study, interpretation of the results, and writing the manuscript. A.V. designed the study and helped to write the manuscript.
Received: 01 July 2021
Accepted: 24 August 2021
26 August 2021 (online)
© 2021. Thieme. All rights reserved.
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- 1 Badrawi N, Hegazy RA, Tokovic E, Lotfy W, Mahmoud F, Aly H. Arrhythmia in the neonatal intensive care unit. Pediatr Cardiol 2009; 30 (03) 325-330
- 2 Jaeggi E, Öhman A. Fetal and neonatal arrhythmias. Clin Perinatol 2016; 43 (01) 99-112
- 3 Texter KM, Kertesz NJ, Friedman RA, Fenrich Jr AL. Atrial flutter in infants. J Am Coll Cardiol 2006; 48 (05) 1040-1046
- 4 Turner CJ, Wren C. The epidemiology of arrhythmia in infants: a population-based study. J Paediatr Child Health 2013; 49 (04) 278-281
- 5 Tseng WC, Wu MH, Chen HC, Kao FY, Huang SK. Ventricular fibrillation in a general population - a national database study. Circ J 2016; 80 (11) 2310-2316
- 6 Davis AM, Gow RM, McCrindle BW, Hamilton RM. Clinical spectrum, therapeutic management, and follow-up of ventricular tachycardia in infants and young children. Am Heart J 1996; 131 (01) 186-191
- 7 Weiner GM, Zaichkin J. eds. Textbook of Neonatal Resuscitation (NRP), 7th ed. Chicago, IL: American Academy of Pediatrics and American Heart Association; 2016: 326
- 8 de Caen AR, Maconochie IK, Aickin R. et al; Pediatric Basic Life Support and Pediatric Advanced Life Support Chapter Collaborators. Part 6: pediatric basic life support and pediatric advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations. Circulation 2015; 132 (16, suppl 1) S177-S203
- 9 de Caen AR, Berg MD, Chameides L. et al. Part 12: pediatric advanced life support: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015; 132 (18, suppl 2) S526-S542
- 10 Sawyer T, Stavroudis TA, Ades A. et al; Organization of Neonatal-Perinatal Training Program Directors Task Force on Simulation. Simulation in neonatal-perinatal medicine fellowship programs. Am J Perinatol 2020; 37 (12) 1258-1263
- 11 Hall MJ, Adamo G, McCurry L. et al. Use of standardized patients to enhance a psychiatry clerkship. Acad Med 2004; 79 (01) 28-31
- 12 Ojha R, Liu A, Rai D, Nanan R. Review of simulation in pediatrics: the evolution of a revolution. Front Pediatr 2015; 3: 106
- 13 Roggen A, Pavlovic M, Pfammatter JP. Frequency of spontaneous ventricular tachycardia in a pediatric population. Am J Cardiol 2008; 101 (06) 852-854
- 14 Physician specialty data report. Accessed September 9, 2021 at: https://www.aamc.org/what-we-do/mission-areas/health-care/workforce-studies/interactive-data/number-people-active-physician-specialty-2019
- 15 American Board of Pediatrics. Pediatric Physicians Workforce Data Book, 2017–2018. Accessed September 9, 2021 at: https://www.abp.org/sites/abp/files/pdf/pediatricphysiciansworkforcedatabook2017-2018.pdf
- 16 Binkhorst M, van der Aar IM, Linders M. et al. Training practices in neonatal and paediatric life support: a survey among healthcare professionals working in paediatrics. Resusc Plus 2021; 5: 100063
- 17 Binkhorst M, Coopmans M, Draaisma JMT, Bot P, Hogeveen M. Retention of knowledge and skills in pediatric basic life support amongst pediatricians. Eur J Pediatr 2018; 177 (07) 1089-1099
- 18 Kumar D, Vachharajani AJ, Wertheimer F. et al; Organization of Neonatal Training Program Directors Task Force on Simulation. Boot camps in neonatal-perinatal medicine fellowship programs: a national survey. J Neonatal Perinatal Med 2019; 12 (02) 231-237
- 19 Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med 2011; 12 (01) 33-38
- 20 The American Board of Pediatrics. Content outline: neonatal-perinatal medicine. Accessed September 9, 2021 at: https://www.abp.org/sites/abp/files/pdf/neonatal_perinatal_content_outline.pdf