According to the CDC, the birth rate of the United States in 2019 was 11.4 per 1000 people. It means that approximately 3750000 new fragile lives are brought into this world yearly- most in need of healthcare faculties. Many children are both with intricate and life threatening conditions. CDC reports that while over 8% of children are born underweight and weak, about 10% are born prematurely. These alarming figures highlight the need for better and specialized healthcare for the young patients. As a healthcare provider or aspirant, you might already have some degrees or understanding of the route to help these struggling children. However, there are other high-demand certifications, such as neonatal resuscitation program, which you should consider. Let’s look at this certification in detail and discuss the neonatal resuscitation process.
What Is Neonatal Resuscitation Program Certification
Neonatal resuscitation program (NRP) certification is a specialized program launched by the American Academy of Pediatrics (AAP) for newborn/neonatal care. It standardizes healthcare and ensures services provided are of quality. The program regularly adds new content aimed at improving healthcare servicesfor newborns. The updates make it necessary to stay in touch with new techniques and require regular NRP certification and recertification.
Since neonatal healthcare requires knowledge, quick assessment, and delicate practical skills, the course covers lectures, as well as written and on-site skill examinations.
But what exactly is covered in the program?
The certification allows you to understand and identify the need for resuscitation.The course helps you specialize in anticipating the need of and initiating resuscitation and providing the best course of action in the stated emergency. On receiving the certification, you would have theoretical and practical knowledge of the skills needed for resuscitation.
Benefits of Certification
The certification certainly improves the quality of healthcare provided, helps save multiple lives, and enables the hospital to maintain its accredited status. It also offers several benefits to the person applying as well. If you work in the delivery room or nursery, the knowledge from the certification will make your practice safer. If you face any emergency, you will know exactly what to do. Moreover, since the course covers cardiopulmonary and respiratory issues, such as asphyxia, and techniques to manage them, NRP is open to respiratory therapists too.Having an NRP certification strengthens your resume and helps you accelerate your career. It allows you to have greater chances at senior job openings in your domain.
Need To Apply For Recertification
Neonatal care is under constant research and improvement; the AAP updates its curriculum by adding new practices. Along with the update, the certification needs renewal periodically. Each NRP certificate has a life of two years, after which you need to reappear for the program. If you already have the certification and want to extend it, you need to take a shorter course (which focuses mainly on the updates) and take a test. Recertification provides approximately half CEUs/CME of the initial certification, allowing you to regain expertise and title with little effort in a few days after completing the course.
Neonatal Resuscitation Overview and Skills Required For Certification
In the delivery room, there is at least one person appointed to take care of the newborn. This person could be you and you might need to initiate and carry out the NRP. Hence the certification requires you to gain some skills to be able to handle the emergency. Let’s look at them in detail.
Identifying the Need to ApplyNeonatal Resuscitation
The first skill is to identify the need of resuscitation and prepare for it. You need a rapid evaluation of term gestation, reaction of the newborn (crying or breathing), and good muscle tone. If the delivery is premature or you find clues related to trouble breathing, it is a call to start resuscitation.
Initiating the Process
If the newborn needsresuscitation, you move on to preparing the patient by controlling temperature for warmth, cleaning and drying the newborn, and proceeding to attempt opening the airways. Most premature babies are likely to be hyperthermic so additional warming techniques are used to avoid the resuscitation being ineffective. After warming up, the umbilical fluid is removed from the mouth and then the nose through suction.
Techniques Deployed in the Process
Several techniques are used in resuscitation process including ventilation, chest compressions, intubation, and end-of-life care. The equipment is prepared before the delivery as a proactive move when the need for resuscitation is anticipated.
The most important part of resuscitation is the ventilation of the lungs, hence PPV is used foremost.
Positive Pressure Ventilation (PPV) is provided when the newborn is gasping and trouble breathing. A mask is placed on the mouth providing free-flowing oxygen to assist the breathing, while chest movement is observed. If the initial PPV doesn’t work, the mask is repositioned, the mouth and nose suctioned again and the pressure is increased. The main goal is to aerate the lungs without harming the fragile newborn, hence the pressure and the method of introduction are delicate yet effective.
It is important to ensure that the ventilation process is rhythmic and not hasty. Often one breath is set for 3 seconds. If the chest does not move, the next step is to insert an ET or laryngeal mask with PPV. The ET tube size is dependent on the gestational age.
Heart rate is used to check the effectiveness of PPV. If the heart rate is consistently less even though the chest movement is sighted, then chest compressions are used. The use of cardiac monitors is recommended to keep a check if the infant’s breathing is not vigorous. Free flow oxygen is used when the oxygen saturation is below the standard even after following previous steps. It helps elevate the oxygen level in the blood of the infant.
Another technique is continuous positive airway pressure (CPAP). It is used on premature newborns or infants with low oxygen saturation. It clears the airway passage and helps the infant get oxygen.
If PPV and CPAP do not prove to be effective, healthcare providers might resort to epinephrine and other medicines. The volume of epinephrine is subject to the bodyweight of the infant.
In rare cases, an umbilical venous catheter (UVC) might be needed. The catheter is added while the chest compression is still being applied.This resuscitation technique harnesses the umbilical cord as it is most accessible and is a direct entry point in an infant. This way the medicines can be injected effectively and in a small time.
Pathway to NRP Certification
Signing up for the NRP certification is a multistep process. Before you can take the course, you need to appear for a pre-examination online.Then, you have to take the course within the next 30 to 90 days depending on the course you select. The courses are instructor-led and most of them are self-paced as the students have access to online lectures and self-study sessions.The hands-on skill classes are valuable practice sessions as they often rely on clinical scenarios simulation. Active participation also leads to mastering skills required for certification and safe practice. Moreover, you need to study the textbook: Neonatal Resuscitation, 8th Edition. After completing the course and being familiar with the textbook content, you need to take an online exam. The online test is taken in two parts in the Online Examination tab of the AAP website. After the exam results in the AAP issuing CEU credits. Various platforms assist in completing the course and use practice tests for better attempts.
In a Nutshell
Infants need special care and medical assistance when born prematurely or weak. Neonatal resuscitation can help them have a chance at life using specialized techniques. The concerned staff can provide quality healthcare to newborns with certifications from AAP based on skills and online tests. Achieving an NRPcertification or recertification is a simple process that can not only accelerate your career but also help you learn valuable skills and training.