Original Article Guidelines for care of the newborn baby at birth knowledge by prehospital emergency physicians Pascal Be ´ londrade a , Hugues Lefort b, *, Kilian Bertho c , Jean-Christophe Perrochon d , Daniel Jost b , Jean-Pierre Tourtier b , Jean-Louis Chabernaud e a Service des urgences/Samu, Centre hospitalier de Cayenne, rue des Flamboyants, BP 6006, 97300 Cayenne, France b Service me ´dical d’urgence, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, 75017 Paris, France c Antenne me ´dicale spe ´cialise ´e de Satory, 34, rue de la Martinie `re, 78000 Versailles, France d Service de sante ´ des arme ´es, SMPR, 55, rue du Faubourg-Saint-Honore ´, 75008 Paris, France e Smur pe ´diatrique (Samu 92), Poˆle FAME, Hoˆpital Antoine-Be ´cle `re, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France 1. Introduction In France, the out-of-hospital emergency medical system is a 2- tiered response system: a basic live support (BLS) tier served by teams of 3 professional rescuers and an advanced life support (ACLS) tier served by emergency physicians. In France, 5 out of 1000 deliveries occur out of the hospital [1] and each of these patients receives care from a rescue team with an emergency physician, unaccompanied by a midwife or obstetrician. Fortu- nately, the practice of newborn resuscitation at birth is an uncommon situation (about 1% of births) but is considered the most stressful and feared practice by emergency practitioners. Even experienced emergency physicians who are trained to conduct adult cardio-resuscitation generally feel difficulty when faced with a newborn baby. In 2010, the International Liaison Committee on Resuscitation (ILCOR) published guidelines on caring for a newborn baby immediately after birth, which were specific to delivery rooms [2–4]. The aim of this work was to assess the practical and theoretical knowledge of these guidelines by out-of-hospital emergency physicians. 2. Materials and methods A questionnaire (Appendix 1) was proposed to out-of-hospital emergency physicians practicing in Paris and suburban districts through a web survey (‘‘mon-enquete-enligne.fr 1 ’’). An alternative was to fill out a paper questionnaire. The questions were created from the 2010 ILCOR guidelines [2–4]. After general questions surrounding the physician’s profile (number of years of experience, initial training, lifelong learning education, experience, etc.), the physician had to answer 25 single (SCQ) or multiple-choice (MCQ) questions about newborn care at birth. Answers were anonymized Anaesth Crit Care Pain Med xxx (2015) xxx–xxx A R T I C L E I N F O Article history: Available online xxx Keywords: Guidelines Neonatal resuscitation Daily practice Newborn child Birth ILCOR A B S T R A C T Introduction: In 2010, the International Liaison Committee On Resuscitation (ILCOR) guidelines for care of the newborn baby immediately after birth were published. Materials and methods: Using a questionnaire that was distributed to a sample of 44 prehospital emergency physicians (April 2014), we assessed knowledge of these guidelines, in particular specificities for newborns as compared to adults. Twenty-five questions, starting with a birth with no problems to one resulting in neonatal distress, were used to profile the practice of the surveyed physicians. Results: Among the solicited physicians, 30 responded to the questionnaire (68%). Priority was given to efficient respiratory resuscitation during the first minutes of extrauterine life and the difficulties of newborn respiratory adaptation are well-known, but their implementation remains imperfectly understood. The assessment showed very mixed results, partly explained by the low frequency of newborn scenarios experienced by the practitioners who responded to the questionnaire. Conclusion: To move from guidelines to their practical implementation is always delicate, with room for improvement such as continuing education, knowledge assessment and practice in the context of a quality approach. Well accepted, this evaluation process could be renewed upon publication of the next guidelines on this subject, thus contributing to their knowledge. ß 2015 Socie ´ te ´ franc ¸aise d’anesthe ´ sie et de re ´ animation (Sfar). Published by Elsevier Masson SAS. All rights reserved. * Corresponding author. Tel.: +33 6 62 38 95 86. E-mail address: hdlefort@gmail.com (H. Lefort). G Model ACCPM-64; No. of Pages 7 Please cite this article in press as: Be ´ londrade P, et al. Guidelines for care of the newborn baby at birth knowledge by prehospital emergency physicians. Anaesth Crit Care Pain Med (2015), http://dx.doi.org/10.1016/j.accpm.2015.06.004 http://dx.doi.org/10.1016/j.accpm.2015.06.004 2352-5568/ß 2015 Socie ´te ´ franc ¸aise d’anesthe ´ sie et de re ´ animation (Sfar). Published by Elsevier Masson SAS. All rights reserved.