~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dear All, We recently had a similar discussion on another list, and this was one of the most evidence-based messages then (forwarded with the permission of the original poster): The thing that strikes me is, if we reckon we can train SHOs (interns?) in six months, why can't we do the same (or better) with our midwives who are on the units for much longer? All the best Tim Ferguson Community Paediatrician, UK <!--- ---> -----Original Message----- From: Ian Verber [SMTP:] Sent: Monday, January 12, 1998 5:00 PM To: Alan Gibson; john bridson Cc: RCPCH discussion group Subject: Re: Elective Caesarian Sections Four years ago we audited the need for intubation following deliveries. We found there was no increased need for intubation following c/section (even under ga) when the indications were maternal - eg previous caesar; delay in first stage etc. The need for intubation was no more than the occasional crash call to a normal delivery. We have now stopped attending these deliveries with no increase in the number of crash calls (Reaudit performed over 6 month period). I didnt think of publishing this work because I thought evryone else was already doing this and we were behind the times! Three cautions:- 1 This does not apply to c/s for fetal reasons:- eg fetal bradycardia, mec stained liquor. 2 The midwives must be trained and competant in face mask ventilation - but doesn't this apply to midwives attending ANY delivery? 3 There must be a foolproof system of crash calling a paediatrician - we have a labour ward bleep which is passed from hand to hand so the labour ward has only one bleep number to remember. (We used a notebook tied to the labour ward bleep to facilitate the 2 audits.) Ian Verber North Tees General