Laryngeal Mask Use in the Neonatal Population: A Survey of Practice Providers at a Regional Tertiary Care Center in the United States
Laryngeal Mask Use in the Neonatal Population: A Survey of Practice Providers at a Regional Tertiary Care Center in the United States
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DOI：
10.1055/s-0041-1736662
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发表时间：
2021-11-02
影响因子：
2
通讯作者：
Szyld, Edgardo
中科院分区：
文献类型：
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作者：
Shah, Birju A.;Foulks, Arlen;Szyld, Edgardo
目的本研究的目的是评估新生儿实践提供者使用喉罩（LM）的培训、意识、经验和信心水平，并找出在新生儿人群中实施喉罩的障碍。研究设计：描述性观察研究，在俄克拉荷马州儿童医院的医疗保健提供者中使用匿名在线问卷，这些医疗保健提供者通常对新生儿分娩做出反应，并接受过新生儿复苏计划（NRP）的培训。参与者包括医生、实习生、执业护士、护士和呼吸治疗师。结果95名参与者完成了调查（27.5%的应答率）。样本包括77名NRP提供者（81%），11名讲师（12%）和7名讲师导师（7%）。在72名接受LM培训的受访者中，51人（54%）进行了实际操作的假人练习，4人（4%）观看了美国儿科学会（AAP）NRP教育视频，17人（18%）两者都做了。护士（46人中的39人）比医生（47人中的31人）更有可能完成LM培训。只有11名（12%）参与者曾在新生儿中放置LM，新生儿复苏期间LM放置的中位置信度为37（0至100分）。经常报告的新生儿使用LM的障碍是经验有限（81%）、培训不足（59%）、偏好气管插管（57%）和缺乏意识（56%）。结论：虽然大多数新生儿实践提供者都接受过LM放置培训，但只有少数人曾将LM放置在活产新生儿中，总体信心程度较低。未来的实践改进应包括正在进行的跨学科LM教育，LM在劳动和交付单位的可用性，并提高LM作为替代气道的认识。
Objective The aim of this study was to evaluate the level of training, awareness, experience, and confidence of neonatal practice providers in the use of laryngeal mask (LM), and to identify the barriers in its implementation in the neonatal population. Study Design Descriptive observational study utilizing an anonymous online questionnaire among healthcare providers at the Oklahoma Children's Hospital who routinely respond to newborn deliveries and have been trained in the Neonatal Resuscitation Program (NRP). Participants included physicians, trainees, nurse practitioners, nurses, and respiratory therapists. Results Ninety-five participants completed the survey (27.5% response rate). The sample consisted of 77 NRP providers (81%), 11 instructors (12%), and 7 instructor mentors (7%). Among 72 respondents who had undergone LM training, 51 (54%) had hands-on manikin practice, 4 (4%) watched the American Academy of Pediatrics (AAP) NRP educational video, and 17 (18%) did both. Nurses (39 out of 46) were more likely to have completed LM training than were physicians (31 out of 47). With only 11 (12%) participants having ever placed a LM in a newly born infant, the median confidence for LM placement during neonatal resuscitation was 37 on a 0 to 100 scale. Frequently reported barriers for LM use in neonates were limited experience (81%), insufficient training (59%), preference for endotracheal tube (57%), and lack of awareness (56%). Conclusion While the majority of the neonatal practice providers were trained in LM placement, only a few had ever placed one in a live newborn, with a low degree of confidence overall. Future practice improvement should incorporate ongoing interdisciplinary LM education, availability of LM in the labor and delivery units, and promotion of awareness of LM as an alternative airway.