The development and implementation of a multidisciplinary neonatal resuscitation team in a Canadian perinatal centre

Resuscitation. 2005 Jul;66(1):45-51. doi: 10.1016/j.resuscitation.2004.12.017.


Purpose: To describe the implementation of a multidisciplinary neonatal resuscitation team (NRT) at a Canadian tertiary perinatal centre.

Methods: In February 2002, the primary role of neonatal resuscitation was transferred from attending physicians (on-call off-site) to a NRT (consisting of a neonatal intensive care nurse, a respiratory therapist, and, when available, a resident, clinical associate (supervised licensed physician), or nurse practitioner). The NRT attended moderate- and high-risk deliveries (in the latter case, accompanied by a neonatologist). Normal, low-risk deliveries remained the responsibility of caseroom (delivery room) staff, assisted by the NRT when concerns arose. A prospective assessment was performed of resuscitation requirements and outcomes.

Results: : Over 24 months, the NRT attended 2944 (64.5%) out of 4565 deliveries. The NRT attended 2497 moderate-risk deliveries, providing positive pressure ventilation (in 15.7% of cases), chest compressions (0.1%), and epinephrine (adrenaline) (0.08%). There were no neonatal deaths or morbidities related to resuscitation in this cohort. A small, but significant, proportion of babies with no identifiable risk factors required resuscitation by caseroom staff (in most cases with brief periods of positive pressure ventilation).

Conclusion: Assignment of level of risk provides a safe means of delivering neonatal resuscitation services, facilitating NRT attendance at the majority of deliveries that required resuscitation. A NRT can perform safely and effectively in a tertiary perinatal centre with off-site support from experienced neonatal staff at high-risk deliveries only. Caseroom (delivery room) staff should continue to be trained in neonatal resuscitation.

MeSH terms

  • Analysis of Variance
  • Cardiopulmonary Resuscitation / methods
  • Cardiopulmonary Resuscitation / standards
  • Chi-Square Distribution
  • Clinical Competence / standards
  • Delivery Rooms / standards
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / standards*
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Newfoundland and Labrador
  • Patient Care Team / standards*
  • Resuscitation / methods*
  • Resuscitation / standards*
  • Resuscitation / statistics & numerical data