Abstract
Objective The accuracy, timeliness, and reliability of the current methods of heart rate (HR)
determination in neonatal resuscitation are debatable, each having its own limitations.
We aim to compare three methods of HR assessment: (1) traditional stethoscope, (2)
electrocardiogram and traditional stethoscope, and (3) digital stethoscope with loudspeaker
amplification of heart sounds.
Study Design This was a simulated crossover experiment using a high-fidelity manikin. Each team
with a physician, a nurse, and a respiratory therapist performed the resuscitations
using the three methods (three different scenarios) in different order. The person
controlling the HR via manikin controller was blinded, but the single recorder and
the providers were not.
Results Eighteen resuscitations were completed (six teams of three methods each). The time
to first HR recording (p < 0.001), total number of HR recorded (p < 0.001), and time to recognize dips in HR was significantly improved in the digital
stethoscope group (p = 0.009).
Conclusion Use of digital stethoscope with amplification improved documentation of HR and earlier
recognition of HR changes.
Key Points
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Amplified heartbeats during neonatal resuscitation improved documentation.
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Amplified infant heartbeats resulted in earlier recognition of HR changes (increase
or decrease).
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Providers using this method had greater satisfaction.
Keywords
digital stethoscope - heart rate amplification - neonatal resuscitation
