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July
2009: VOLUME
6, NUMBER 11
T-Piece Resuscitators in the Delivery Room
In
this Issue...
The ideal device for delivering positive pressure ventilation during neonatal resuscitation has not been clearly established. While the most common practice remains the use of either flow-inflating or self-inflating bags, use of the T-piece resuscitator, a pressure-limited, manually cycled device, is becoming more common. The device is simple to use and requires a minimum of training. Recent research on all manual resuscitation devices used in the delivery room has focused on the amount of ventilation that is sufficient, how consistently it can be provided, and whether pressure or volume measurements are better than chest wall movement as an indicator of adequate ventilation.
In this issue, we review publications that describe the risks and benefits of T-piece resuscitators compared with other resuscitation devices, including consistency of peak inspiratory pressure, volume/rate, and positive end expiratory pressure. Additional concerns, including the safety of the device, the ability of the T-piece resuscitator to overcome leaks, and whether users can recognize and adapt to compliance changes using the T-piece, are also reviewed. Because the face mask is the first and most critical interface to the infant lung used by caregivers, this issue will also cover the impact of the mask and its design on the efficacy of these resuscitation devices.
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At
the conclusion of this activity, participants should be better able to:
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Describe the risks and benefits of the T-piece resuscitator
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Discuss the disadvantages associated with the use of pressure-limited devices during resuscitation
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Identify two methods of ensuring that mask pressure is being properly delivered to the infant |
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IMPORTANT
CME/CNE INFORMATION |
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accreditation
statements
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Nurses
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Respiratory Therapists
Respiratory therapists should visit this page to confirm that AMA PRA Category 1 Credit(s)™ is accepted toward fulfillment of RT requirements.
credit designations
Physicians
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation on the activity. (Each newsletter: 1.0 AMA PRA Category 1 Credit™; each podcast: 0.5 AMA PRA Category 1 Credits(s)™. A maximum of 15 AMA PRA Category 1 Credit(s)™ are available for the entire program.)
Nurses
This 1 contact hour educational activity is provided by The Institute for Johns Hopkins Nursing. Each newsletter carries a maximum of 1 contact hour for each of the 12 newsletters and 0.5 contact hours for each of the 6 podcasts in this program.
Respiratory Therapists
For United States: Visit this page to confirm that your state will accept the CE Credits gained through this program.
For Canada: Visit this page to confirm that your province will accept the CE Credits gained through this program.
There are no prerequisites or fees associated with this activity.
Statement of support
This activity is supported by an educational grant from Ikaria.
Launch date
April 30, 2009; activities expire 2 years from the date of publication ending on March 31, 2012.
Successful completion
To successfully complete this activity, participants must read the content, complete the post-test with a passing grade of 70%, and complete the evaluation.
Participants can access and print statements of credit after successful completion of this activity.
disclaimer statement
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine or The Institute for Johns Hopkins Nursing name implies a review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients. |
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post-test
To take the post-test for eNeonatal Review you will need to access The Johns Hopkins School of Medicine or The Institute for Johns Hopkins Nursing websites; links are provided throughout the website and newsletters. If you have already registered for other Hopkins CE programs through these sites, simply enter the requested information when prompted. Otherwise, please complete the registration form to begin the testing process.
statement of responsibility
The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing take responsibility for the content, quality and scientific integrity of this CME/CNE activity.
intended audience
This activity has been developed for neonatologists, NICU nurses and respiratory therapists working with neonatal patients. There are no fees or prerequisites for this activity.
internet cme/cne policy
The Office of Continuing Medical Education (OCME) at The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing are committed to protecting the privacy of its members and customers. Johns Hopkins maintains its Internet sites as information resources and services for physicians, other health professionals, and the public.
Continuing Medical Education at The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing will keep your personal and credit information confidential when you participate in a CE Internet-based program. Your information will never be given to anyone outside these institutions. CE collects only the information necessary to provide you with the service you request.
faculty disclosure
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:
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Edward E. Lawson, MD has indicated a financial relationship of grant/research support from The National Institutes of Health (NIH). He also receives financial/material support from Nature Publishing Group as the Editor of Journal of Perinatology. |
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Lawrence M. Nogee, MD has indicated no financial relationship with any commercial supporters. |
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Christoph U. Lehmann, MD has indicated a financial relationship of honoraria from Mead Johnson and Pediatrix. |
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Mary Terhaar, DNSc, RN has indicated no financial relationship with any commercial supporters. |
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Anthony Bilenki, MA, RRT has indicated no financial relationship with any commercial supporters. |
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Guest
Author’s Disclosures |
hardware & software requirements
Pentium 800 processor or greater, Windows 98/NT/2000/XP or Mac OS 9/X, Microsoft Internet Explorer 5.5 or later, 56K Modem or better, Windows Media Player 9.0 or later, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader. |
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Program
Directors
Edward
E. Lawson, MD
Professor of Pediatrics
Johns Hopkins University School of Medicine
Chief, Division of Neonatology
Vice Chair, Department of Pediatrics
Johns Hopkins Children's Center
Christoph
U. Lehmann, MD
Associate Professor
Department of Pediatrics
Division of Neonatology
The Johns Hopkins University
School of Medicine
Lawrence
M. Nogee, MD
Professor
Department of Pediatrics
Division of Neonatology
The Johns Hopkins University
School of Medicine
Mary
Terhaar, DNSc, RN
Assistant Professor
Undergraduate Instruction
The Johns Hopkins University
School of Nursing
Anthony Bilenki, MA, RRT
Technical Director
Respiratory Care Services
Division of Anesthesiology and Critical Care Medicine
The Johns Hopkins Hospital
Baltimore, Maryland
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GUEST
AUTHORS OF THE MONTH |
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Commentary & Reviews |
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Wade Rich, BSHS, RRT, CCRC
Research Coordinator Division of Neonatology
University of California,
San Diego (UCSD) Medical Center
San Diego, California
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Commentary |
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Neil Finer, MD
Professor of Pediatrics
UCSD Medical Center
San Diego, California
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Guest
Faculty Disclosure
Wade Rich, BSHS, RRT, CCRC
has no relevant financial relationships to disclose.
Neil Finer, MD has no relevant financial relationships
to disclose.
Unlabeled/Unapproved Uses
Dr. Finer has indicated that he does reference the off-label use of the Pedi-Cap® in the Commentary.
Program
Directors' Disclosures |
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COMPLETE
THE
POST-TEST
Step
1.
Click on the appropriate link below. This
will take you to the post-test.
Step
2.
If you have participated in a Johns Hopkins
online course, log in. Otherwise, please register.
Step
3.
Complete the post-test and course evaluation.
Step
4.
Print out your certificate.


Respiratory Therapists
Visit
this page to confirm that your state will accept the CE Credits gained
through this program or click on the link below to go directly to the post-test.
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