Preventing neonatal falls and accidents in the Delivery Room.

[Guest enaid1]

Should the common practice of "hand carry" of newborns to the warming table be changed perhaps to... the OB or delivering practitioner placing the newborn in an awaiting bassinette prepped with a sterile drape and then rolled over to the warming table? What are your thoughts? We are seriously looking into this as an accident just waiting to happen.

[Stefan Johansson]

Hi!

I am glad you raise this important safety aspect of the commonly stressful situations.

There was recently a case in Sweden, fortunately nothing serious happened this time.

http://sydsvenskan.se/malmo/article423793/Barnmorska-tappade-nyfodd-pa-golvet.html

When I was a junior doctor I was told by my mentor "never to carry an infant" unless I really had to, to reduce the risk of falls. A message that I translated into the practise of letting the midwifes carry newborn infant from the delivery room to the resuscitation table (I know, not the perfect solution...)

Infants (regardless of gest-age) are always carried by hand after CS or vag delivery, wrapped in cloth to the warmer in the delivery unit/op theatre. From the "local warmer" to the NICU we hardly ever carry infants, but use an incubator for preterm/ill infants, or an infant bed for more well and term infants.

In one unit there are also some pilot work experimenting with transporting stable preterm infants (>32 weeks) skin-to-skin from the delivery unit to the NICU. In practise that means that the father is put with bare chest in a wheel-chair, and the baby on cpap is carried skin/skin by the father (covered with warming cloth). After the wheel.chair comes a pretty large stand with all equipment (cpap, suctioning system etc-etc). Personally, I am not completely convinced this single interveention can further improve our otherwise developed NIDCAP-strategies, but I feel that there's plenty of thinking outside-the-box (literally!) that needs to be done in this research area.

Back to your first question... I think your idea is good! If you already have this discussion I think you also have acceptance among staff for evaluating the use of baby-beds for transports to the warmer. Maybe you could even design some kind of research protocol for this question.