Neonatal Resuscitation is slightly different than resuscitation of infants, because for the first several minutes of life the new baby responds physically more like a fetus. In addition, the lungs of the newborn are uninflated and fluid-filled. This requires a slight change in the resuscitation procedure. Most resuscitation programs in the United States don’t cover neonates, or do so very briefly. The only national certification currently available for neonatal resuscitation is NRP (Neonatal Resuscitation Program);a hospital practice approach based on American Academy of Pediatrics (AAP) and American Heart Association (AHA) guidelines. In addition, currently only delivery-room hospital staff qualify to be certified as NRP instructors.
To meet the needs of the out-of-hospital care provider, Birthingway created the Biodynamic Resuscitation of the Newborn program. This is our own “home-brew” combining aspects of NRP, international resuscitation models, and evidence-based practices. It is similar to other programs in that it is based on a sequence of care provision alternating with assessments and with a progression of care from least to most interventive. However, BRN is unique in several ways:
- Recognition that the fetal stress response continues through the fetal transition period
- Delayed cord clamping to optimize lung perfusion and avoid anemia
- Alternating six-second assessments with 30 seconds of care/action – NRP omits the six-second assessment between the inflation and the first set of ventilation breaths. Because field-based care is provided to newborns who have not been exposed to medications and who are generally low risk, most respond positively to stimulation alone while most of the remainder respond to inflation breaths. A six-second assessment at that point usually results in discontinuing resuscitation, as the baby has responded well.
- Use of room air for the first 90-seconds/two ventilation cycles of resuscitation.
- Recognition of the importance of a calm resuscitation environment to minimize neonatal catecholamines.
- Requires little or no specialized equipment to perform.
Students who complete the program receive certification in Biodynamic Resuscitation of the Newborn (BRN). BRN certification is valid for two years and is approved for midwives to meet the neonatal resuscitation requirement to renew licensure in Oregon state.
As of April 18th, 2011, BRN meets NARM certification and recertification requirements.
BRN training is a stand-alone, five hour workshop taught by a BRN certified instructor and includes both theoretical and hands-on components. To receive BRN certification, you must attend the entire five hour training and pass the written and skills assessments.
BRN workshops are offered annually at Birthingway College in early September, and by arrangement at other times and locations.
To register for BRN, go to the Workshops section of our Registration Page to see when the course will be offered next.
For information about becoming a BRN instructor, contact the College.