Just arrived on-line: a systematic review and meta-analysis (I can imagine Annie’s eyes glazing over right now as she reads those words) of neonatal resuscitation programs. Pammi M, et al. Newborn Resuscitation Training Programmes Reduce Early Neonatal Mortality. Neonatology. 2016;110(3):210-24. Available free on-line.
I have been a PALS instructor, an NRP instructor and regional trainer, and a real believer in evidence-based resuscitation programs, paediatric and neonatal, since they were introduced (not very evidence-based at first, but that has been improving). But being a “believer” is not my style, I would rather be an advocate based on good evidence that such programs actually reduce adverse outcomes. At first there was little good evidence that neonatal resuscitation training programs did that, the evidence was mostly that people improved their skills (according to standards established by the same programs) and were more able to comply with the resuscitation algorithms that those same programs had developed.
We decided to do a systematic review of the available evidence, and found that there was adequate evidence of benefit of NRP type programs.
At the same time, another demonstration of the effectiveness of such programs (not a randomized trial this time, but a valuable publication anyways) Kc A, et al. Reducing Perinatal Mortality in Nepal Using Helping Babies Breathe. Pediatrics. 2016.
I wish I knew how to pronounce “Kc” but, nonetheless, the HBB paradigm led to dramatic improvements in intra-partum stillbirth and early neonatal death in the centers in Nepal where it was initiated.
The intrapartum stillbirth rate decreased from 9.0 to 3.2 per thousand deliveries, and first-day mortality from 5.2 to 1.9 per thousand live births.
That is an effect that ‘risks’ saving hundreds of thousands of babies each year.