Neonatal resuscitation program (NRP) guidelines and timing of major resuscitation events in delivery rooms at a level III NICU: Understanding deviations

Objective: To describe the timing of major resuscitation events in the Delivery room. Methods: A retrospective study of neonates born at a level III birthing hospital who received chest compressions in the delivery room was conducted. The timing of the resuscitation events i.e., intubation, UVC, endotracheal (ETT), epinephrine and intravenous (IV) epinephrine were described. The timing of these events were compared for deliveries with the presence of neonatology team. Results: 51 neonates were included. An alternate airway was secured at 4.24 +/- 5.9 minutes. Endotracheal epinephrine and IV epinephrine were administered at a mean time of 3.98 +/- 3 minutes and 10.87 +/- 5.18 minutes after the initiation of chest compressions respectively. Conclusion: Data from real -life cases on the timeline of events suggest that major resuscitation events as suggested by Neonatal Resuscitation Program Guidelines, are often significantly delayed.