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When faced with a neonatal crisis, every second counts!

Nathan Nagel

By Nathan Nagel

Nathan is the CEO of the Middle East Medical Portal

The longer is takes to find the heart rate the less time you have to help the new born in crisis!

Baby delivered out

Around 1 in 10 babies require of some form of stabilisation at birth. The heart rate of the baby is critical for guiding the stabilisation or resuscitation process; however current monitoring methods do not always provide an timely or accurate enough heart rate. This can lead to uncertainty in the management of the baby’s care. Up to 10% of newborn babies needing some form of stabilisation or resuscitation at birth equals up 14 million babies worldwide annually.

Key challenges faced by clinicians

• Pulse Oximetry significantly underestimates heart rate in the first 2 minutes after birth (Van Vonderen).
• ECG is associated with skin injury and the electrodes are easily dislodged (Katheria).
• In addition Pulseless Electrical Activity (PEA) may delay resuscitation (Johnson).
• Stethoscope-assessed heart rates in the delivery room are inaccurate in 36% of all encounters, 28% to the extent that inappropriate clinical decisions are indicated (Voogdt).

The clinical impact of the problem

Delayed resuscitation can have significant consequences. Newborn survival is improving (in developed countries) but long-term issues such as brain injury and chronic lung disease remain; Cerebral Palsy (CP) can be a consequence of birth trauma. The prevalence of CP has not changed in 40 years, Neonatal hypoxia and encephalopathy remain major causes of CP.

The technology problem

No other heart rate monitor has been specifically designed for newborn babies – they are all adult approaches that have been adapted for newborns!

The solution to the clinical and technology problem.

The SurePulse VS was specifically designed for newborn babies, it facilitates confident decision-making, accurate and reliable heart rate; information is displayed in real-time for the whole clinical team.

The device is wireless which provides significant opportunities for more flexible, evolving, delivery room practices (whilst monitoring heart rate). These include: delayed cord clamping, skin-to-skin care (delivery room cuddles), early breast feeds and less-invasive approaches to stabilization.

The touchscreen and data download facility supports improved patient safety, audit, clinical governance and training. By facilitating a date/time stamped downloadable record of heart rate information and the sequencing of clinical interventions such as CPAP and drug administration, SurePulse VS supports the review of delivery room experience and is fully aligned with existing patient clinical pathways.

SurePulse VS also addresses common problems in the delivery room, the accurate recording of heart rate information and clinical interventions are notoriously inconsistent in the delivery room. The SurePulse VS touchscreen interface makes this a simple and routine activity, it is invaluable should a retrospective review be needed – for example in a Serious Incident Investigation or clinical complaint.

With regard to thermo-protection many babies have a hand-knitted or medical cap put on the head immediately to minimise heat-loss. As the SurePulse VS heart rate sensor is simply integrated into the cap (available in five sizes) then minimal intervention is needed. Clinical trials conducted at the Nottingham Universities NHS Trust established the thermoprotective equivalence of the SurePulse Cap, compared to other commonly used caps.