STABLEize vs nrp

In addition to The S.T.A.B.L.E. Program Module Guidelines: Sugar, Temperature, Airway, Blood pressure, Lab work, Emotional support for the family, this app includes a BONUS menu of 22 severe cardiac anomalies to increase understanding of how blood flows through the heart in the setting of ductal dependent and not ductal dependent congenital heart disease (CHD). - 4 calculators: corrected gestational age, temperature converter (Fahrenheit to Celsius and vice-versa), umbilical artery and venous catheter insertion depth, weight converter (grams to pounds/ounces and vice-versa). - Under Cardiac Anomalies you’ll find animations and information on 22 severe forms of congenital heart disease. The MP4 videos demonstrate how blood flows through the heart with the various forms of CHD, and for ductal-dependent lesions, the severe impact of ductal closure on blood flow. Other animations feature normal heart anatomy, hypercyanotic (tet) spell, and balloon atrial septostomy (Rashkind procedure). Also included are illustrations of palliative procedures (PDA stent, balloon valvuloplasty, BT shunt, RVOT stent, central shunt, pulmonary artery band). STABLE stands for the 6 assessment and care modules in the program: Sugar, Temperature, Airway, BP, Lab work, Emotional support. This app includes the following items: - Sugar module: General Guidelines for sick infants and infants at increased risk for hypoglycemia, IV treatment of a blood sugar less than 50 mg/dL (2.8 mmol/L), useful information about umbilical catheters and actions to correct umbilical artery catheter malpositions. - Temperature module: General Guidelines (hypothermic classifications, monitoring, rewarming after accidental hypothermia), and neuroprotective hypothermia checklist and neurologic exam. - Airway module: monitoring guidelines, respiratory distress descriptions, endotracheal tube sizes and insertion depth, blood gas evaluation, signs of a pneumothorax, and treatment of a pneumothorax. - Blood pressure module: assessment for shock and treatment of shock, including how to mix dopamine hydrochloride to constitute an 800 microgram/mL IV fluid solution. - Lab work module: risk factors for neonatal infection, clinical signs of infection, and laboratory evaluation prior to transport to an intensive care unit. How to calculate the absolute neutrophil count and immature to total ratio. - Emotional support for the family module: the various emotions that parents may be experiencing and how to help families who are experiencing the crisis of a sick newborn. The Cardiac Anomalies menu includes short descriptions and MP4 videos and illustrations for: - Normal Heart and Lungs - Aortic Valve Stenosis - Atrial septal defect - Atrioventricular canal - Coarctation of aorta - Double outlet right ventricle - Ebstein anomaly - Hypoplastic left heart syndrome - Interrupted aortic arch – type B - Patent ductus arteriosus - Pulmonary atresia with intact ventricular septum (IVS) - Pulmonary atresia with IVS and sinusoids - Pulmonary atresia with ventricular septal defect - Total anomalous pulmonary venous connection (TAPVC) – Cardiac, Supracardiac, Infracardiac) - Tetralogy of Fallot (moderate stenosis) - Tetralogy of Fallot (ductal dependent) - Transposition of the Great Arteries - Tricuspid atresia - Truncus arteriosus - Ventricular septal defect Includes illustrations of palliative procedures: balloon atrial septostomy (Rashkind procedure), PDA stent, balloon valvuloplasty, Blalock-Taussig (BT) shunt, right ventricular outflow tract (RVOT) stent, central shunt, pulmonary artery band.

The NRP Assist app is an iOS app designed based on the NRP algorithm 8th edition from 2021 [1]. It assists the NRP provider during resuscitation by giving audio and tactile alerts at appropriate times, based on timers that start at various points along neonatal resuscitation. Thus, it helps them keep track of time during the resuscitation. It reminds the NRP providers to calculate APGARs in real time at 1, 5, 10, 15 and 20 minutes. It also provides the NRP providers with the minor details during resuscitation and displays the goal saturations on the screen, as per the expected SpO2 at various minutes of life. Thus, it makes it easy to assess the goal saturations for the NRP providers. It also makes calculation of epinephrine dose easy, based on the Estimated Fetal Weight (EFW) that is entered on the app before beginning resuscitation. The events for that session will be stored on the phone or iPad being used, thus helping with real-time documentation of events. This final report can be saved as a pdf document or shared with others using email or WhatsApp. Please note that this application is exclusively designed to aid certified NRP (Neonatal Resuscitation Program) providers during resuscitation scenarios and is not intended for use by the general population. Presently, the application is specifically designed to be utilized exclusively within the context of NRP simulation training and is not intended for real-life emergencies. It should not be used outside the context of simulation training. However, it is essential to emphasize that this app is not a substitute for comprehensive medical training or certification in resuscitation techniques. Users must not rely on this app as their sole source of knowledge. Its role is to complement and supplement proper medical training, rather than to replace it. Evidence: 1. Textbook of Neonatal Resuscitation 8th edition Edited by: Gary M. Weiner, MD, FAAP, Jeanette Zaichkin, RN, MN, NNP-BC DOI: https://doi.org/10.1542/9781610025256 Link: https://publications.aap.org/aapbooks/book/694/Textbook-of-Neonatal-Resuscitation?autologincheck=redirected 2. Maya-Enero S, Botet-Mussons F, Figueras-Aloy J, Izquierdo-Renau M, Thió M, Iriondo-Sanz M. Adherence to the neonatal resuscitation algorithm for preterm infants in a tertiary hospital in Spain. BMC Pediatr. 2018 Oct 9;18(1):319. doi: 10.1186/s12887-018-1288-3. PMID: 30301452; PMCID: PMC6178255. 3. Bahr N, Huynh TK, Lambert W, Guise JM. Characterization of teamwork and guideline compliance in prehospital neonatal resuscitation simulations. Resusc Plus. 2022 May 18;10:100248. doi: 10.1016/j.resplu.2022.100248. PMID: 35607396; PMCID: PMC9123265. 4. Patel J, Posencheg M, Ades A. Proficiency and retention of neonatal resuscitation skills by pediatric residents. Pediatrics 2012;130:515–521. 5. Kaczorowski J, Levitt C, Hammond M, Outerbridge E, Grad R, Rothman A, et al. Retention of neonatal resuscitation skills and knowledge: a randomized controlled trial. Fam Med 1998;30:705–711. 6. Cusack J, Fawke J. Neonatal resuscitation: are your trainees performing as you think they are? A retrospective review of a structured resuscitation assessment for neonatal medical trainees over an 8-year period. Arch Dis Child Fetal Neonatal Ed 2012;97:F246–F248.