Medical professionals from six small hospitals across South Dakota are learning how to handle complications during childbirth. Avera Health teams of doctors, anesthesiologists, nurses, and other care providers are working in teams in critical simulations.
Eight medical professionals crowd around a simulator that forces them to figure out how to deliver a baby when its shoulders are stuck. Trainers use a device to measure the pressure a doctor or nurse puts on a baby while trying to free the newborn.
Avera’s Doctor Kimberlee McKay says health care providers in smaller hospitals don’t deliver that many babies, so they encounter few complicated births. She says that means they must rehearse for situations that go wrong. McKay says shoulder dystocia is a good example.
“When you work in a facility like Pierre or Aberdeen where you’re doing 500 or 600 deliveries a year, that will happen one or two percent of the time. But if you think about how often that’s happening up there, maybe that’s two or three times a year. So the maneuvers that you need to do to get a baby out without breaking a bone or without having brain damage are super, super important to practice,” McKay says. “I don’t really like practicing on patients or feeling like I’m practicing at the time that it happens, so what we’re really doing is bringing people into simulations so that they can practice their maneuvers on what we call these pelvic models and fake babies so they know what to do in the event of an emergency.”
The emergency training ranges from situations where babies get stuck to coping with dangerous blood loss for a mom after she delivers to resuscitating a newborn baby.
The training gives doctors a refresher on handling critical situation. Trainers also encourage physicians and nurses to switch roles so they better understand the importance of collaborating during an OB emergency.
Doctor Susan Mann practices medicine in Boston and teaches at Harvard Medical School. She says this delivery training focuses on problems that concern rural health care workers. They have fewer resources than large facilities, especially at night.
“It’s also important the staff understands, how far away do these people live? So that if you anticipate there could be a problem, then it’s better to call them in sooner than to wait until there really is a problem,” Mann says. “Some problems we can anticipate. There’s a much smaller percent that we can’t anticipate; we do as best as we can with those. But if you anticipate there’s a problem, there should be a plan in place for every patient, no matter what size hospital you’re delivering at.”
Mann says the participants can become trainers for other staff at their own hospitals, so all medical professionals involved in obstetrics are prepared for the worst.
Mann says she hopes other rural health providers can benefit from the training techniques she’s developing with Avera. She says she doesn’t know of efforts like this that focus on training staff at smaller hospitals.