1281 Heart Rate Assessment, Right on Time (Heart). Differences Between Health Care Professionals During Simulated Neonatal Resuscitation

Abstract

Background: In simulated neonatal resuscitation 28% of heart rate (HR) assessments are sufficiently inaccurate to change management.Aim: Determine any differences in HR assessment by stethoscope (accuracy and required time) between health care professionals, and relating these differences to participants preferred method for counting HR.Method: A randomized, single blind, simulation study using a VitalSim© manikin. Participants declared their profession and preferred method to determine HR. A digital timer was visible during assessment. HR was randomly set at 40, 50, 70 and 80 BPM. First scenario assessed absolute HR with assessment of HR range (< 60, 60-100,>100 BPM) during bag and mask ventilation in the second scenario and after three cycles of compressions and ventilation in third scenario.Results: There were 147 participants. 37% of assessments were inaccurate of which 92% were overestimates. Accuracy did not differ significantly between professionals. In scenario 1, midwives were slower in HR assessment than specialist registrars (P=< 0.05), but not in scenarios 2 and 3. Assessment of HR range was faster than absolute HR (P=< 0.05). Newborn Life Support (NLS) recommended method to assess heart rate, used in 8.3% of cases, shortened time to determine HR in first scenario as compared to other methods (19 (SD13-23) vs. 23(SD18-32) seconds, P< 0.05). In all scenarios NLS recommended method showed a trend towards increased accuracy (63,3% vs 58,3%).Conclusion: There are only minor between groups of health care professionals in terms of speed and accuracy. The NLS method is faster and may be more accurate.