October 30-November 1, 2012--Neonatal Resuscitation Training

Every baby is only born once.  In the uterus his lungs are full of fluid.  After birth when the baby cries, the fluid in the lungs is absorbed, and the baby breathes air.  Crying is good.

Drying off the baby and wiping his nose and mouth stimulates the baby and helps him breathe.  A baby needs help if he is gasping and/or his heart rate is less than 100.

Step 1:  Positive Pressure Ventilation
If you smell cookies coming out of the oven, you raise your head a little to smell the aroma.  This is the sniffing position.  Put the baby in sniffing position and use the bag and mask to ventilate the baby. (The mask fits over the baby's nose and mouth.  The bag is what the doctor is squeezing.) The waltz step (1,2,3) is the rhythm that you use with the bag and mask to help the baby breathe.  As one medical person is ventilating, the other is checking the heart rate.  It is important to talk to each other.  This is the "golden minute."

After the baby is stable, it is important for the two medics to visit and discuss, "What did we do well?"  And then ask, "What could we do better?" Correct early ventilation solves 90% of the problems. 

Step 2:  Chest compressions (CPR for a newborn)

Step 3:  Intubation--inserting a tube into the mouth and then into the airway.  Dr. Bennett is training the seven doctors that will help teach the training to the large group. 

These doctors know how to do this.  He is showing them some details to make the procedure safer.

Day 2 and 3 with all of the doctors, nurses, etc.  See the doctor in the blue shirt.  This is Jovan that gave us a tour of Kotor Old Town last May.  (See old blog post.)

Dr. Bennett is showing a video of Captain Sullenberger landing his plane on the Hudson River.  Sully had 42 years experience of flying and gliding but had never landed a plane on a river.  He had, however, many years of flight simulation practicing for emergencies.  Simulation works.  If you master proper ventilation (step 1), steps 2 & 3 will be rare occurances.  If you practice on a manikin, you will be ready for those rare moments.  Carolyn shared an experience of a new doctor doing perfect chest compressions on a baby.  The doctor had never done this before but had practiced regularly on a manikin.  Simulation works.

The students take a pretest before the training and the same test again at the end to show they have learned the material.

Jovan receiving his certificate of achievement.

Carolyn, Dr. Danolja Dakic (head neonatologist of the Podgorica Hospital), Dr. Envera Lekic (neonatologist that was our contact person with the hospital--went to Kotor with us last May), Sandra, Rada, Nevena.

Envera arranged for lovely Montenegrin food to be served for lunch.  This is Envera and Dr. Bennett.

This is Natasa.  She does eye surgery on babies. She heard that we were at the hospital and stopped by to see us.  We are talking with her about a vision project.  I met her at the women's club luncheon.

Dr. Bennett has read much about the Balkan countries.  He wanted to see Ostrog Monastery before he left.  (Nevena, Carolyn, George, Marcia)  Envera wrote to us, "We have received only positive comments from the participants of the seminar."  It was a very satisfying experience.