NICU Survey
1.How would you categorize theprimaryhospital you work at?
University Academic Hospital
Children's Hospital
Community Hospital
Private Hospital
2.How would you categorize the level of care in your Neonatal Intensive Care Unit (NICU)?
Level I
Level II
Level III
Level IV
3.What is the total number ofbeds in your NICU?
4.What other Pediatric based ICUs are present in your hospital?
Pediatric ICU
Cardiac ICU
Surgical ICU
Other (please specify)
5.Do you have an upper age limit for patients admitted toyour NICU (e.g. 44 weeks postmenstrual age, etc.)?
Yes
No
if yes, what is the upper limit?
6.Do you readmit patientsor accept transfers from other hospitals, pediatric clinics or ER to your NICU?
Yes
No
7.Which of the following providers would bemostlikely to LEAD a cardiopulmonary resuscitation of patient in your NICU?
Pediatric Resident
NICU Fellow
NICU Attending
Neonatal Nurse Practitioners or Physician Assistants
NICU Hospitalisit
8.Which practitioners working in your NICU are currently REQUIRED to maintainPALSprovider status?
(check as many as apply)
Nurses (LPN, RN)
Neonatal Nurse Practitioners or Physician Assistants
NICU hospitalists
Pediatric Residents
NICU Fellows
NICU Attendings
Respiratory Therapists
Pharmacists
None of the above
I don't know
Please explain if not all your providers are required to maintainPALS
9.Which practitioners working in your NICU are currently REQUIRED to maintainNRPprovider status?
(check as many as apply)
Nurses (LPN, RN)
Neonatal Nurse Practitioners or Physician Assistants
NICU hospitalists
Pediatric Residents
NICU Fellows
NICU Attendings
Respiratory Therapists
Pharmacists
None of the above
I don't know
Please explain if not all your providers are required to maintain NRP
10.Does your NICU have a policy concerning which national resuscitation program guidelines NRP, PALS should be used during cardiopulmonary resuscitation of patients in your NICU?
Yes*
No
If yes please enter your contact information and email a copy of the guidelines to information you submit will remain deidentified
11.At what age after birth do YOU THINK PALS guidelines should be used, rather than NRP guidelines, for resuscitation of patients in the NICU? (PLEASE SELECT ONLY ONE ANSWER FOR EACH AGE)
Preterm infants (born or admitted at 22 wks gestation to 37 wks gestation)
Immediately after leaving the delivery room (e.g. all resuscitations outside the DR should follow PALS)
≥ 24hrs of life
≥ One (1) week of life
≥ 28 days of life
≥ Three (3) months of age
≥ Six (6) months of age
≥ One (1) year of age
Other:
Other (please explain)
12.At what age after birth do YOU THINK PALS guidelines should be used, rather than NRP guidelines, for resuscitation of patients in the NICU?(PLEASE SELECT ONLY ONE ANSWER FOR EACH AGE)
Term infants (born or admitted at 38 wks gestation to 42 wks + gestation)
Immediately after leaving the delivery room (e.g. all resuscitations outside the DR should follow PALS)
≥ 24hrs of life
≥ One (1) week of life
≥ 28 days of life
≥ Three (3) months of age
≥ Six (6) months of age
≥ One (1) year of age
Other
Other (please explain)
13.Independent of age, for what specific scenarios do you think PALS* guidelines should be used, rather than NRP* guidelines, for patients in the NICU?
*PALS defined as compression to ventilation ratio of 15:2 if no advanced airway is in place andasynchronous compressions (100bpm) with ventilations (8-10 breaths/min) if an advanced airway is in place. NRP defined as compression to ventilation ratio of 3:1
(CHECK AS MANY AS APPLY)
Any resuscitation outside of the delivery room
Ventricular fibrillation or pulseless V-tach
Asystole or pulseless electrical activity (PEA)
Symptomatic bradycardia
Arrest due to upper airway obstruction
Arrest due to lower airway obstruction
Arrest due to lung tissue (parenchymal) disease
Arrest due to disordered control of breathing
Arrest due to hypovolemic shock
Arrest due to obstructive shock (tension pneumothorax, cardiac tamponade)
Arrest due to distributive (septic) shock
Arrest due to cardiogenic shock
Arrest in a baby with structural congenital heart disease
Arrest in a baby with bronchopulmonary dysplasia
Arrest in a baby with pulmonary hypertension
Arrest in a baby with hypoxemic respiratory failure
Arrest in a baby with hypercarbic respiratory failure
Arrest in a neonate receiving mechanical ventilation
Arrest in a neonate with multi-organ system failure
Prolonged resuscitation (>2 minutes of CPR)
Prolonged resuscitation (>5 minutes of CPR)
Prolonged resuscitation (>10 minutes of CPR)
Prolonged resuscitation (>15 minutes of CPR)
Continued resuscitation (i.e. persistent bradycardia/asystole/PEA) once confirmation of adequate ventilation established
Arrest on ECMO
Other
Other (please specify)
14.During cardiopulmonary arrest in your NICU, which of the following best describes the most common approach to starting CPR?
one rescuer starts CPR with chest compressions, while a second rescuer prepares to provide ventilations (chest compressions before ventilations)
one rescuer starts CPR with ventilations, while a second rescuer prepares to provide compressions (ventilations before chest compressions)
one rescuer provides CPR with chest compressions at the same time a second rescuer provides ventilations (simulataneous chest compressions and ventilations)
15.Current International Liaison Committee on Resuscitation (ILCOR)guidelines recommend that newborns (intubated or not) who require Cardiopulmonary Resuscitation (CPR) in the newborn nursery or NICU receive CPR using the same technique as for the newly born in the delivery room (ie, 3:1 compression-to-ventilation ratio with a pause for ventilation).Circulation. 2010 Oct 19;122(16 Suppl 2):S516-38
Do you agree with this statement?
Yes
No
16.CurrentILCORguidelines recommend that newborns who require CPR in other settings (eg, prehospital, ED, PICU, etc.), should receive CPR according to infant guidelines: 2 rescuers provide continuous chest compressions with asynchronous ventilations if an advanced airway is in place and a 15:2 compression-to-ventilationratio if no advanced airway is in place (Class IIb, LOE C).Circulation. 2010 Oct 19;122(16 Suppl 2):S516-38
Do you agree with this statement?
Yes
No
17.Current NRP guidelines state that NRP should “apply primarily to newly born infants… but the recommendations are also applicable to neonates who have completed perinatal transition and require resuscitation during the first few weeks to months following birth.”Textbook of Neonatal Resuscitation, 6th Edition. 2011. Pages 255-261
Do you agree with this statement?
Yes
No
18.Current PALS guidelines state that in delivery room, newborn nursery or NICU that NRP should be used. In other settings, for newborns who require CPR, the infant PALS guidelines should be used for ease of training.Circulation. 2010;122:S876-S908
Do you agree with this statement?
Yes
No
19.Do you believe there should be specific guidelines on when to use PALS orNRP for resuscitation of patients in the NICUbased on the age (Chronologic or Postmenstrual) of the patient?
Yes
No
If yes why?
20.Do you believe there should be specific guidelines on when to use PALS vs. NRP for resuscitation of patients in the NICUbased on the etiology of the arrest (i.e cardiac, respiratory, shock)?
Yes
No
If yes why?
21.In regards to cardiopulmonary arrest of patients in the NICU, which do YOU consider most important in the decision on when to change from NRP to PALS guidelines?
Chronologic age after birth (e.g. days or weeks of life)
Postmenstrual age (e.g. weeks gestation + days or weeks of life)
Underlying etiology of arrest (i.e cardiac, respiratory, shock)