Response
We welcome the enquiries about our MedNav neonatal resuscitation navigation and we would like to thank the correspondent's comments and suggestions to improve our decision support system.
The protocol we use does not need specific heart rates put into the system in order to work; however, it does need the user to confirm three options for the heart rate of the baby. The protocol as the correspondent has noted is not dependent on the tone of the baby initially; however, at 5 and 10 minutes we do ask the user about the tone of the baby (not in flow diagram). The correspondent mentions that the algorithm will fail to pick up a baby with normal breathing that might need resuscitation if the heart rate is abnormal or its tone is abnormal or both. In our clinical experience if a baby has normal breathing / crying, the heart rate is not a concern and it is not normally assessed in clinical practice; however, the software has a specialist button that can be accessed for rare or specialist cases (not included in the flow diagram) and the final prompt is to warm, monitor and consider oxygen if necessary. We have updated the flow diagram for obstructed airways and several options now exist.
Our MedNav decision support tool for neonatal resuscitation is improving performance and as part of our ongoing research we have implement several iterations of the protocol to improve performance further. We welcome further comments and we look forward to continuing our work in this area.
- © Royal College of Physicians 2018. All rights reserved.
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