A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

Table 1

LPCH neonatal resuscitation program curriculum¹.

Hour	Method of instruction	Session content
1	Lecture	(i) Neonatal resuscitation curriculum overview and need
		(ii) Fetal circulation and oxygenation
		(iii) Fetal complications after labor
		(iv) Signs of compromised infant
		(v) Supplies needed for neonatal resuscitation
		(vi) Determination of need for resuscitation
		(vii) Initial assessment
		(a) Term
		(b) Amniotic fluid
		(c) Respirations
		(d) Tone
		(viii) Initial steps
		(a) Warming technique
		(b) Drying technique
		(c) Infant positioning to open airway
		(d) Clear airway
		(e) Stimulation technique
		(ix) Infant vitals
		(a) Respirations
		(b) Heart Rate
		(c) Color
		(x) Advanced techniques
		(a) Positive pressure ventilation
		(b) Chest compressions
		(xi) NRP-based special considerations adapted to local context
2-3	Demonstration with trainee practice and instructor feedback^2	(i) Warming technique
		(ii) Drying technique
		(iii) Infant positioning for open airway
		(iv) Suctioning techniques
		(a) Oral
		(b) Nasal
		(c) Deep
		(v) Stimulation technique
		(vi) Bag-valve-mask technique
		(vii) Chest compression technique
4	Scenarios^3	(i) Unexpected depressed infant
		(ii) Maternal preterm delivery and hemorrhage
		(iii) Hypothermia
		(iv) Meconium
		(v) Depressed infant due to sedation
5-6	Lecture	(i) Review
		(ii) Question and Answer Session

¹ NRP has 7 lessons: (1) Principles of Resuscitation, (2) Initial Steps in Resuscitation, (3) Bag and Mask Ventilation, (4) Chest Compression, (5) Endotracheal Intubation, (6) Medications, and (7) Special Considerations. The LPCH NRP-based curriculum incorporates lessons (1), (2), (3), (4), and (7).
² Infant mannequins are used for demonstrations and trainee practice sessions.
³ NRP scenarios are adapted to local context and read by course instructor. Trainees react to the scenario while practicing resuscitation skills on infant mannequins. Instructor provides feedback as necessary on sequential steps of proper neonatal resuscitation for each scenario.