Effect of flow rate, humidifier dome and water volume on maximising heated, humidified gas use for neonatal resuscitation.

AIM: Dry, cold gas is used for neonatal resuscitation, contributing to low admission temperatures and exacerbation of lung injury. Recently, a method of heating and humidifying neonatal resuscitation gases has become available. We aimed to determine the optimal flow rate, humidifier chamber and water volume needed to reach 36°C, and near 100% humidity at the patient T-piece in the shortest possible time. METHOD: A T-piece resuscitator was connected via a heated patient circuit to a humidifier chamber. Trials were performed using different gas flow rates (6, 8 and 10L/min), humidification chambers (MR290, MR225) and water volumes (30g, 108g). Temperature was recorded at the humidifier chamber (T1), distal temperature probe (T2) and the T-piece (T3) over a 20min period at 30s intervals. A test lung was added during one trial. RESULTS: No significant difference existed between flow rates 8L/min and 10L/min (p=0.091, p=0.631). T3 reached 36°C and remained stable at 360s (8L/min, MR225, 30mL); near 100% RH was reached at 107s (10L/min, MR225, 30mL). T3 and humidity reached and remained stable at 480s (10L/min, MR290, 30mL). Target temperature and humidity was not reached with the test lung. CONCLUSIONS: It is possible to deliver heated, humidified gases in neonatal resuscitation in a clinically acceptable timeframe. We suggest the set-up to achieve optimal temperature and humidity for resuscitation purposes is 10L/min of gas flow, a MR290 humidification chamber, and 30mL of water.

Training on selected self-management techniques and the generalization and maintenance of interpersonal skills for registered nurse students.

This study examined the effects of training on selected self-management procedures (post-workshop practice, self-monitoring, self-assessment, and self-reinforcement) on the generalization and maintenance of interpersonal skills with a group of registered nurse students. The findings indicate that those self-management procedures enabled the student nurses to maintain a positive attitude toward the use of interpersonal skills in their work and maintain their skill level over a period of time significantly better than a control group who received interpersonal skills training only. No significant differences were observed between the two groups as to their ability to maintain their knowledge of the concepts taught during training or their ability to generalize their skills to the hospital ward immediately following training.