Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table

doi:10.3389/fped.2022.952489

. 2022 Nov 2:10:952489.

doi: 10.3389/fped.2022.952489. eCollection 2022.

Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table

Linus Olson^{1

2

3

4}, Xuan Anh Bui⁵, Allan Mpamize⁶, Hien Vu^{7

8}, Jolly Nankunda^{9

10}, Tung Thanh Truong⁷, Josaphat Byamugisha¹¹, Tina Dempsey^{4

12}, Clare Lubulwa⁹, Axel Winroth¹³, Daniel Helldén⁴; NeoSupra & NeoSpirit Teams; Anh Duy Nguyen¹⁴, Tobias Alfvén^{4

15}, Nicolas Pejovic^{4

15

16}, Susanna Myrnerts Höök^{4

15

16}

Affiliations

¹ Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
² Training and Research Academic Collaboration (TRAC) Sweden - Vietnam, Hanoi, Vietnam.
³ Neonatal Department, Vietnam National Children's Hospital, Hanoi, Vietnam.
⁴ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
⁵ Department of Information Technology, Phu San Hanoi Hospital, Hanoi, Vietnam.
⁶ Dr. Ronald Batte Hospital, Entebbe, Uganda.
⁷ Social Department, Phu San Hanoi, Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam.
⁸ Department of International Collaboration, Phu San Hanoi Hospital, Hanoi, Vietnam.
⁹ Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda.
¹⁰ Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampal, Uganda.
¹¹ Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Makerere, Uganda.
¹² Astrid Lindgren Children's Hospital, Karolinska University Hospital, Solna, Sweden.
¹³ Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.
¹⁴ Department of Hospital Administration, Phu San Hanoi Hospital, Hanoi, Vietnam.
¹⁵ Sachs' Children and Youth Hospital, Stockholm, Sweden.
¹⁶ Centre for International Health, University of Bergen, Bergen, Norway.

PMID: 36405840
PMCID: PMC9666784
DOI: 10.3389/fped.2022.952489

Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table

Linus Olson et al. Front Pediatr. 2022.

. 2022 Nov 2:10:952489.

doi: 10.3389/fped.2022.952489. eCollection 2022.

Authors

Affiliations

¹ Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
² Training and Research Academic Collaboration (TRAC) Sweden - Vietnam, Hanoi, Vietnam.
³ Neonatal Department, Vietnam National Children's Hospital, Hanoi, Vietnam.
⁴ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
⁵ Department of Information Technology, Phu San Hanoi Hospital, Hanoi, Vietnam.
⁶ Dr. Ronald Batte Hospital, Entebbe, Uganda.
⁷ Social Department, Phu San Hanoi, Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam.
⁸ Department of International Collaboration, Phu San Hanoi Hospital, Hanoi, Vietnam.
⁹ Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda.
¹⁰ Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampal, Uganda.
¹¹ Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Makerere, Uganda.
¹² Astrid Lindgren Children's Hospital, Karolinska University Hospital, Solna, Sweden.
¹³ Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden.
¹⁴ Department of Hospital Administration, Phu San Hanoi Hospital, Hanoi, Vietnam.
¹⁵ Sachs' Children and Youth Hospital, Stockholm, Sweden.
¹⁶ Centre for International Health, University of Bergen, Bergen, Norway.

PMID: 36405840
PMCID: PMC9666784
DOI: 10.3389/fped.2022.952489

Abstract

Background: The quality of neonatal resuscitation after delivery needs to be improved to reach the Sustainable Development Goals 3.2 (reducing neonatal deaths to <12/1,000 live newborns) by the year 2030. Studies have emphasized the importance of correctly performing the basic steps of resuscitation including stimulation, heart rate assessment, ventilation, and thermal control. Recordings with video cameras have previously been shown to be one way to identify performance practices during neonatal resuscitation.

Methods: A description of a low-cost delivery room set up for video recording of neonatal resuscitation. The technical setup includes rechargeable high-definition cameras with two-way audio, NeoBeat heart rate monitors, and the NeoTapAS data collection tools for iPad with direct data export of data for statistical analysis. The setup was field tested at Mulago National Referral Hospital, Kampala, Uganda, and Phu San Hanoi Hospital, Hanoi, Vietnam.

Results: The setup provided highly detailed resuscitation video footage including data on procedures and team performance, heart rate monitoring, and clinical assessment of the neonate. The data were analyzed with the free-of-charge NeoTapAS for iPad, which allowed fast and accurate registration of all resuscitative events. All events were automatically registered and exported to R statistical software for further analysis.

Conclusions: Video analysis of neonatal resuscitation is an emerging quality assurance tool with the potential to improve neonatal resuscitation outcomes. Our methodology and technical setup are well adapted for low- and lower-middle-income countries settings where improving neonatal resuscitation outcomes is crucial. This delivery room video recording setup also included two-way audio communication that potentially could be implemented in day-to-day practice or used with remote teleconsultants.

Keywords: NeoBeat; NeoTap; neonatal diagnostics; neonatal resuscitation; quality improvement; video camera; video recording.

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Conflict of interest statement

SMH, NP, CL, and TA are co-founders of the non-profit organization Tap4Life (www.tap4life.org), which produced the free-of-charge application NeoTapAS. The authors do not receive any salary from Tap4Life. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Video camera process for Uganda (A) and Vietnam (B) from the insertion of SD card into camera to video recording and final cut ready for analysis.

**Figure 2**
A real capture from a video showing the situation at the resuscitation table with NeoBeat on the neonate's chest and only hands shown.

**Figure 3**
The process from delivery to verified video captured resuscitation, Uganda, and Vietnam.

**Figure 4**
(A) The capture of setting up version 1. (B) The capture of setting up version 2. (C) Camera close-up.

**Figure 5**
App software of the camera in Vietnam.

See this image and copyright information in PMC

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References

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[1] United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & trends in child mortality: Report 2021. Estimates developed by the United Nations Inter-Agency Group for child mortality estimation. New York (2021). - PMC - PubMed

[2] United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & trends in child mortality: Report 2021. Estimates developed by the United Nations Inter-Agency Group for child mortality estimation. New York (2021). - PMC - PubMed

[3] World Health Organization. Newborn mortality internet. Factsheet; (2022) (Cited January 03, 2022).

[4] World Health Organization. Newborn mortality internet. Factsheet; (2022) (Cited January 03, 2022).

[5] United Nations, Sustainable Development Knowledge Platform. Sustainable Development Goals (2021). Available from: https://sdgs.un.org

[6] United Nations, Sustainable Development Knowledge Platform. Sustainable Development Goals (2021). Available from: https://sdgs.un.org

[7] Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. (2015) 385(9966):430–40. 10.1016/s0140-6736(14)61698-6 - DOI - PubMed

[8] Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. (2015) 385(9966):430–40. 10.1016/s0140-6736(14)61698-6 - DOI - PubMed

[9] GBD 2019 Under-5 Mortality Collaborators. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet. (2021) 398(10303):870–905. 10.1016/s0140-6736(21)01207-1 - DOI - PMC - PubMed

[10] GBD 2019 Under-5 Mortality Collaborators. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet. (2021) 398(10303):870–905. 10.1016/s0140-6736(21)01207-1 - DOI - PMC - PubMed

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Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table

Affiliations

Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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