Recent discussions
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Виктория Антонова
I am a LDRP nurse and I am almost finished with my certified nurse midwife program. But most importantly I am a mother to two children who received NRP. I could not get up and be nearby while they received resuscitation because I was still in the middle of a cesarean section but my husband was not allowed to go back with them even though I requested he be able to. I Believe that parents should have the right to determine whether or not they want to witness and be involved in the resuscitation. Like every other situation they should be able to make the decision about what they feel is best for their family in that moment in time. One of my children has complex congenital heart defects that has required many hospitalizations including open heart surgery and ecmo. Thankfully we have not been put in a position where she has required any type of resuscitation outside of the OR but if we had been presented with that situation I would want to stay by her side and witness the resuscitation. That is important to me. Not all parents would feel the same But I feel that I have a right to make the decision For myself and my family -
Виктория Антонова
I very much agree on the importance of the presence of parents during neonatal resuscitation. It is a very complicated moment for professionals and painful for the family, but it is necessary to be together in the procedures and decisions for the best outcome. -
Виктория Антонова
I think this should be a variable option related to local standards and cultures of each health care setting in different countries. I believe some parents would not be able to tolerate stressful resuscitation experience to their sick newborn who needed a lot of interventions even the outcome came good. However, others will tolerate and even be grateful to the resuscitation team for their efforts. I think it should be individualized. -
Виктория Антонова
I think family needs to be defined, as sometimes husband not available, grandparents sometimes available only. Mother can’t see baby , lot of people around resuscitoir, also c sec vs delivery suite makes lot of difference for such arguments. Presence in room vs actual viewing of resuscitation?? Needs lot of clarification plus effect on team etc -
Виктория Антонова
I agree that the presence and participation of parents in all times of babies journey is essential, even in critical situations such as resuscitation (contribution from Brazil). -
Виктория Антонова
I think that even though there (still) seems to be not enough hard evidence for familiy presence it is also our ethical duty to allow and even encourage family presence. After all it is imperative to build and strenghten patient/family autonomy! -
Виктория Антонова
Parents attending resuscitation reflect back that they knew 'everything was done' and seem to be more comforted, even though it's hard to watch. We have one member of staff updating the parents which is of course easier for us in a tertiary centre. I always invite parents to witness, if they refuse that is their choice. - ANNP. -
Виктория Антонова
I thank everyone involved for their effort. I agree the evidence is so weak that perhaps no official recommendation should be made at this time. Given that the majority of neonatal resuscitations are immediately post birth at least one parent, the mother, is typically in the room unless the infant is removed to be resuscitated elsewhere. Given that the mother and often a support person are present, one focus should be on how much involvement they have in the resuscitation. The “parents “ are rarely more than 20 feet away and often the crib/ table is adjacent to the mother’s bed. Hence they are witness to the efforts being made to resuscitate their infant. The individual leading the resuscitation can clearly explain the steps being taken to improve the infants condition with comments such as “ we are placing a tube into your baby’s mouth to help her/ him breathe “, similarly for catheters, etc. If not someone at the infants side then another medical person in the room can relay the information. The process is 10-15 minutes after which the infant is taken over to the “parents” to show how he/ she was stabilized or to allow them to hold if the results were unfavorable. Effort should be directed toward how best to communicate during this brief period. Resuscitation in the nursery or NICU is a different set of circumstances and may be best discussed separately. I am a neonatologist covering both a level 3 facility and a community hospital simultaneously for 35 years in the US. Thank you. -
Виктория Антонова
I agree with the supportive comments and have always allowed family to be present. It is most helpful to have one trained staff person who can stay with the parent, supporting & calmly but briefly explaining what is happening. If parent’s emotional reaction is distracting to the team, they can step out of the room with that staff person. Filming by the family is discouraged / not allowed but if it occurs, is from a distance. -
Виктория Антонова
I think there is no way way to make a specific recommendation. It needs to almost be a case by case situation. Parents should always have a part in the care of their child. Sometimes though that part may interfere with people doing their job well. If we do a full resuscitation in the delivery room there is barely enough room for all the staff, also given what is happening you almost need a person to support and explain things to the parents, we usually will not have extra staff to do this if we have a full code going on.