The Laryngeal Mask Empowering Nurses to Rescue Newborns
The Laryngeal Mask Empowering Nurses to Rescue Newborns
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DOI：
10.1097/anc.0000000000001044
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发表时间：
2023-04-01
影响因子：
1.7
通讯作者：
Rhein, Michelle
中科院分区：
文献类型：
--
作者：
Zaichkin, Jeanette;McCarney, Linda D.;Rhein, Michelle
背景资料：自2005年以来，新生儿复苏计划（NRP）已推荐喉罩（LM）作为正压通气（PPV）不成功和插管不成功或不可行时的替代气道。关于LM在高资源国家的使用的文献很少;然而，轶事信息和最近的研究表明低implementation.Purpose：本文增加了LM的安全性和有效性的认识，为确定护理实践范围提供了指导，并包括制定培训计划的建议。方法包括考虑NRP客户的问题，最近的文献系统综述，如何制定NRP建议，如何确定护理实践范围，发现/结果：最近的研究支持NRP的建议，即当PPV失败且插管不可行时，使用LM作为抢救气道。LM提供比面罩通气更有效的PPV。对于至少34周妊娠的婴儿，LM作为初始PPV器械可能有效。要使用LM，护士可能需要培训，其中可能包括基于模拟的courses.Implications实践：护士可以提高他们的意识LM使用的优势，确定他们的实践范围，并制定培训计划。当面罩通气是不成功的，插管是不可行的，LM插入将可能增加新生儿的心率，避免interventions.Implications研究：未来的研究应确定培训要求，LM作为初始PPV设备在高资源设置的疗效，LM在复杂的复苏和早产儿使用。
Background: Since 2005, the Neonatal Resuscitation Program (NRP) has recommended the laryngeal mask (LM) as an alternative airway when positive-pressure ventilation (PPV) is unsuccessful and intubation is unsuccessful or unfeasible. There is a paucity of literature regarding LM use in high-resource countries; however, anecdotal information and recent studies suggest low implementation.Purpose: This article increases awareness of LM safety and efficacy, provides guidance for determining nursing scope of practice, and includes suggestions for developing a training program.Methods: Methods include considering NRP customers' questions, recent systematic reviews of the literature, how NRP recommendations are developed, how to determine nursing scope of practice, and how to develop a training program.Findings/Results: Recent studies support the NRP recommendation to use the LM as a rescue airway when PPV fails and intubation is not feasible. The LM provides more effective PPV than face-mask ventilation. The LM may be effective as the initial PPV device for infants of at least 34 weeks' gestation. To use the LM, nurses may require training, which may include a simulation-based curriculum.Implications for Practice: Nurses can increase their awareness of the advantages of LM use, determine their scope of practice, and develop a training program. When face-mask ventilation is unsuccessful and intubation is unfeasible, LM insertion will likely increase the newborn's heart rate and avoid intubation.Implications for Research: Future research should determine training requirements, efficacy of the LM as the initial PPV device in high-resource settings, and LM use during complex resuscitation and in preterm newborns.