News From Terre Haute, Indiana

March 28, 2014

Healthy moms, Healthy babies

Pros ramp up neonatal techniques in face of high mortality rate

Dianne Frances D. Powell
The Tribune-Star

TERRE HAUTE — A woman is in active labor when suddenly, an emergency occurs. What do you do?

Wabash Valley health care professionals on Friday learned — or got a refresher — on how to handle different kinds of delivery situations.

Nurses, paramedics, respiratory therapists, physicians and pharmacists from Putnam County Hospital and Sullivan County Community Hospital participated in a training course that aims to equip them with the necessary skills to handle neonatal emergencies and care of newborns.

The training program, developed by the Rural Health Innovation Collaborative was at Union Hospital in Terre Haute. The attendees, about 16 of them, worked with human patient simulators at the RHIC’s Simulation Center.

The training is part of the Collaborative’s neonatal outreach program and is an an effort to reduce Indiana’s infant mortality rate, said Jack E. Jaeger, Simulation Center director. The program aims to educate health care professionals from rural areas and critical access hospitals on the stabilization of newborns and neonatal emergencies. The majority of babies in Indiana are born in facilities that do not have neonatal intensive care units, according to a release.

Jaeger said the hope is for the participants to learn how to assess a newborn, see what’s wrong and share this knowledge with their peers. These health care professionals often work on teams, he said.

Inside one delivery room Friday, a team of four participants worked in a fictional scenario where a 20-year-old patient with no local doctor, no prenatal care, but with a history of drug use was in active labor.

Beth Hall, a nurse in Sullivan County Community Hospital, said encouraging words to the human patient simulator during the scenario as if she were talking to a real woman delivering a baby. When the baby was born, she wrote the time of birth on the board — 1:37 p.m. — while the others examined the baby, checked its heart rate and cleaned it up. Then, the sound of baby crying was heard inside the room.

“We came with our hospital because they want us to make sure we are well-rounded,” Hall, who has been an OB nurse for 19 years, said. “That we can handle normal things and also the emergencies.”

During the simulation, Hall said, the mother had extra bleeding, but she quickly addressed it.

“With some things, when you catch it right away, you can make it go away,” she said.

Even though she has been a nurse for 19 years, the training was a good reminder of what to do in emergency situations. One instructor, Toni Earleywine, said the teams were given three scenarios: one, normal delivery; two, an obstetric emergency known as shoulder dystocia (when the shoulders do not get delivered after the baby’s head); three, post-partum hemorrhage.

“We want them to be much more comfortable in dealing with different scenarios and being able to provide care in these situations,” Earleywine said.

Participants also watched recordings of the simulations, while discussing what they did well and what they can improve upon. An instructor gave them tips and suggestions during these debriefings.

Indiana State Health Commissioner William C. VanNess II toured the Simulation Center and praised the work being done in the area.

“It’s absolutely state of the art,” VanNess said. “This is the kind of education needed in the state.”

In another room, Nurse Sondra Bowen of Putnam County Hospital was part of the team that dealt with shoulder dystocia. The veteran ER nurse said the class has helped her get more experience in handling pre-term deliveries and sick babies. Because the hospital does not have an OB department, babies are often born in the ER, she said.

“It’s all new, so the practice is good,” Bowen said.

Situations can either be good or bad, she said, and can turn bad quickly. “So you have to be ready for all of it,” she said.

Tribune-Star Reporter Dianne Frances D. Powell can be reached at 812-231-4299 or