Critical Care
Medical Education
Neonatology
Lindsay Gilmore, MD (she/her/hers)
Neonatal-Perinatal Fellow
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Mark Castera, MD (he/him/his)
Neonatal-Perinatal Medicine Fellow
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Kesi Yang, MD (she/her/hers)
Assistant Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Wallingford, Pennsylvania, United States
Elizabeth Wetzel, MD, MS (she/her/hers)
Assistant Professor of Clinical Pediatrics
Pediatrics
Riley Hospital for Children at Indiana University Health
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana, United States
Noorjahan Ali, MD
Assistant Professor of Pediatrics
University of Texas Southwestern Medical School
Dallas, Texas, United States
Workshop
Description: Successful management of High Acuity, Low Occurrence (HALO) events requires specific cognitive, technical, and behavioral skills. The Neonatal Resuscitation Program (NRP) provides a framework that addresses these skills in the context of the delivery room. However, this framework and associated skills may not be applicable to the complex and heterogeneous population of infants admitted to the NICU. Anticipating, preparing for, and responding to a wide variety of complex resuscitation scenarios (HALO events) is challenging but required given the risk of mortality. Challenges include limitations of current resuscitation guidelines (NRP vs PALS), lack of comfort with non-delivery room resuscitations, significant cognitive load during HALO events, and lack of appropriate cognitive aids. Many of these challenges can be addressed with targeted, technology-enhanced simulation training, which has consistently been associated with improvements in knowledge, technical skills, and behaviors. Simulation can be utilized to make HALO events more familiar, thus improving provider performance and patient outcomes. Simulation allows providers a platform to practice rare procedures, integrate cognitive aids, and utilize novel resuscitation roles and technologies. Additionally, simulation provides a safe space to critically evaluate resuscitation skills through structured debriefing. The use of simulation is a necessity in the increasingly complex world of neonatal and infant resuscitation and should be utilized to improve resuscitation practices.