Dr. Elizabeth Wetzel (Indiana University)

1. ALERT Presentation: Comparison of
ETT/UVC vs. LMA/IO in NRP
Bobbi J. Byrne, MD and Elizabeth A. Wetzel, MD
Indiana University School of Medicine
IMSH 2013: Orlando, Florida / USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• The Neonatal Resuscitation Program (NRP)
has traditionally taught intubation and
emergency umbilical venous catheterization
in delivery room crisis situations. These skills
can be technically challenging for providers
who do not often use them.
International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question
• P: Healthcare providers that perform intubation and emergency UVC
placement
• I: LMA and IO procedures taught as alternatives for airway management
and vascular access in a simulated delivery room scenarios.
• C: compared to ETT with UVC placement.
• O: take less time to perform and have a higher success rate
“In healthcare providers that perform intubation and emergency UVC
placement would LMA and IO procedures taught as alternatives for airway
management and vascular access in a simulated delivery room scenario
take less time to perform and have higher success rates compared to
ETT/UVC?”
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Approach / Design
Target population: Healthcare providers that may need to perform airway management and
emergency vascular access in the delivery room
Healthcare providers
Participation in standardized skills stations with
separate videos and hands on practice with facilitator
led instruction for intubation, UVC placement, LMA
placement and IO placement
Participants are randomized into
two groups (either ETT with UVC
or LMA with IO placement)
ETT with UVC LMA with IO
placement placement
Participation in a standardized Participation in a standardized
simulated delivery room scenario simulated delivery room scenario
of a neonatal placental abruption of a neonatal placental abruption
International Network for Simulation-based Pediatric Innovation, Research and Education

5. 3 Questions to improve study
1. We have utilized the NRP procedure checklist when
observing the simulation scenario, should a mastery
skills checklist be incorporated into the skills stations?
2. We are currently using standardized scripts for our
facilitators in the skills station and scenario, do we
need to develop a structured train-the-trainer module?
3. As we expand the study to more skilled providers
should any aspects of the study change?
International Network for Simulation-based Pediatric Innovation, Research and Education

6. Contact Information
Bobbi J. Byrne, MD
Indiana University School of Medicine
bjbyrne@iupui.edu 317-274-4716
http://medicine.iu.edu
International Network for Simulation-based Pediatric Innovation, Research and Education