www.laerdal.info/neonatalie

Realistic and affordable training and therapy

In support of the UN MDG 4 Laerdal has committed to providing the NeoNatalie Newborn Simulator and the NeoNatalie resuscitation tools to developing countries on a not-for-profit basis through 2015

NeoNatalie

Highly realistic simulation training at a low costNeoNatalie has realistic size and appearance, and also natural weight, feel and touch when filled with lukewarm water. The baby´s status can be simulated as desired for effective role playing in relevant scenarios covering normal care after birth as well as standard resuscitation measures.

NeoNatalie facilitates effective learning of standard new-born care and resuscitation measures. The low cost simulator is available with affordable therapeutic tools.

Use squeeze bulbs to simulate- birth cries- spontaneous breathing- palpable umbilical pulse

NeoNatalie was developed to help train millions of birth attendants in developing countries in neonatal resuscitation courses, such as “Helping Babies Breathe”*

NeoNatalie Suction The suction unit is made in one piece of silicone, can be boiled or autoclaved,

and withstands hundreds of uses. Shaped like a penguin, its beak is ideal for newborn oral and nasal suction. Head can be tilted aside

for easy emptying and cleaning.

NeoNatalie ResuscitatorThe bag-valve-mask unit is made of silicone and polysulphonate, can be boiled

or autoclaved, and is extremely durable. Comes with two mask sizes. Time proven design and quality. An oxygen kit is an optional extra.

NeoNatalie is easily prepared for use by filling the body

with two liters of water, or alternatively with air.

NeoNatalie facilitates practice in effective bag-mask-ventilation. Chest will only rise

with correct technique.* Helping Babies Breathe (HBB) is an initiative of the American Academy of Pediatrics in collabo-ration with the World Health Organization (WHO), US Agency for International Development, Saving Newborn Lives, the National Institute of Child Health and Human Development (NICHD), and a number of other global health organizations. For more information; see www.helpingbabiesbreathe.org

Helping Babies BreatheSM

A Global Public-Private Alliance

For more information, see: www.helpingbabiesbreathe.orgwww.usaid.gov, www.nichd.nih.gov, www.savethechildren.org, www.laerdal.info/neonatalie, www.aap.org

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© American Academy of Pediatrics, 2010ISBN 978-1-58110-495-0

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CLINICAL REMINDER

Helping Babies Breathe

Preparation for a birth

Identify helper and review

emergency plan.

Prepare the area for delivery.

Wash hands. Prepare an area for ventilation and check equipment.

Position the headslightly extended.

Position the mask on the face.

Seal mask airtight to face with thumb and index

finger on top of the mask.

Squeeze the bag to move the chest gently,

40 times per minute.

How to ventilate

How to improve ventilation

Head: Reapply the mask to the face to form

a better seal. Reposition the head with the neck slightly extended.

Mouth:Clear secretions as necessary and open the mouth slightly.

Bag:Squeeze the bag harder to give

a larger breath.

How to clean equipment after use

1. Take apart bag and mask device for cleaning.

2. Wash all parts using a suitable detergent. Rinse carefully with clean water to remove all remaining detergent. Leave to air dry.

3. Decontaminate by one of the following methods: - Steam autoclaving. - Chemical disinfection with activated glutaraldehyde. Rinse thoroughly in clean water. - Boiling in water for at least 10 minutes.

4. Dry completely and keep clean until next use.

Equipment must be discarded or cleaned according to manufacturer’s directions before reuse.

© American Academy of Pediatrics, 2010ISBN 978-1-58110-494-3

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Helping Babies BreatheSM Training Program by the American Academy of Pediatrics

Action Plan wall posterClinical Reminder wall poster26 FlipchartsLearner Workbook

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5

Evaluation after drying

Is the baby crying?

Helping Babies Breathe Learner WorkbookHelping Babies Breathe Learner Workbook

Helping Babies Breathe Learner Workbook

The Challenge: Four Million Newborns Die in the First Month of Life

Every year an estimated four million newborns die during their first month of life. Half of these deaths occur during delivery and within the next 24 hours, often as a result of inadequate or lack of breathing. Evidence indicates that lifesaving care can significantly reduce neonatal mortality as stated by the Millennium Development Goal (MDG) 4: to reduce child mortality by two-thirds before 2015.

Every year 10 million babies require help to breathe immediately after birth. Simple means to stimulate breathing, including drying and rubbing, and ventilation with bag and mask, could save the majority of these babies. Such lifesaving care is currently only available for less than one out of four newborns.

Therefore, in order to meet the Millennium Development Goal 4, birth attendants in large numbers must acquire the basic skills and equipment to help newborns breathe.

The Response: Helping Babies Breathe - A Global Public-Private Alliance

Alliance PartnersUSAID, through its Global Development Alliance model,is partnering with: • The Eunice Kennedy Shriver National Institute of Child and Human Development, a US Government agency which will lead the evaluation of the alliance; • Save the Children, an independent global organization which provides global technical expertise and advocacy for effective newborn health interventions through its Saving Newborn Lives program; • Laerdal Medical, a world wide developer, manufacturer and distributor of lifesaving training tools and equipment; and• The American Academy of Pediatrics, a professional association dedicated to the health, safety and well-being of infants, children, adolescents and young adults, which provides an evidence-based curriculum called Helping Babies BreatheSM.

USAID provides technical expertise in newborn health and supports the rollout of newborn resuscitation through its Implementing Partners: Maternal and Child Health Integrated Program (MCHIP), Health Care Improvement (HCI), HealthTech (PATH), CORE Group and bilateral programs. MCHIP is implemented by Jhpiego, Save the Children Federation, Inc., Johns Hopkins University/Institute for International Programs, Program for Appropriate Technology in Health (PATH), John Snow, Inc., Macro International, Inc., Broad Branch Associates, and Population Services International (PSI). HCI is implemented by the University Research Co. LLC. HealthTech is implemented by PATH. The CORE Group is a member organization of over 50 non-governmental organizations.

Guiding PrinciplesThe Alliance partners have agreed to the following principles to significantly expand the impact of development assistance by leveraging their resources, expertise and creativity:• Inclusiveness and Collaboration: The Alliance will welcome coordination of activities with other agencies if such relation- ships contribute to the achievement of the goal of this Alliance; • Country Owned and Country Led: The resuscitation program will be embedded within the national health plan that is developed and owned by the Government. The Alliance will play a supportive role to countries that request assistance to expand newborn resuscitation;

• Integration: The Alliance will integrate resuscitation within a broader package of essential newborn care including early and exclusive breast-feeding, thermal protection, clean cord care, and early identification and management of infections and low birth weight; • Shared Goal, Results and Recognition: The Alliance will work towards a common goal of reducing newborn mortality, and share results, risks, and recognition of program implementation; • Brand Non-Exclusivity: The Alliance will strive to expand access to newborn resuscitation for all newborns that need it by being open to all high quality and affordable resuscitation devices that governments and partners may choose to include in their programs.

© Jenny Matthews

The United States Agency for International Development (USAID) partners with the private sector as a key strategy for scaling up lifesaving newborn care around the world. This public-private alliance will strive to increase neonatal survival by offering evidence-based training and high quality affordable resuscitation devices to birth attendants in developing countries.

Purpose• Promote global commitment and resources for lifesaving newborn care.• Improve the availability of high-quality, appropriate and affordable newborn lifesaving training materials and equipment. • Improve the lifesaving competencies of birth attendants.• Strengthen the supply chain for lifesaving newborn resuscitation devices.• Help health systems provide a sustainable high-quality newborn lifesaving program.• Evaluate the impact of neonatal lifesaving programs at scale.

Nozzle dimensions at tip: Inner diameter (ID): 3.0 mm Outer diameter (OD): 4.5 mm

Suction strength (typical): 100 mmHg [136 cmH2O]

Operating temperature: 0 °C (32 °F) to 50 °C (122 °F)

Storage temperature: -20 °C (-4 °F) to 60 °C (160 °F)

Material: Silicone

medicaldevics@who.int

1.5 Reusable neonatal suction system

References;1. Lawn, J.E, Lee, A.C, Kinney, M., Sibley, L., Carlo, W.A., Paul, V.K., Pattinson, R., Darmstadt, G.L. Two million intrapartum-related stillbirths and neonatal deaths: Where, why, and what can be done? IJGO 2009; 107: s5-19.

2. WHO, Managing Newborn Problems: A guide for doctors, nurses, and midwives. WHO, Geneva, 2003.

3. American Heart Association, American Academy of Pediatrics. American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) of Pediatric and Neonatal Patients: Neonatal Resuscitation Guidelines (2005)

4. Narayanan, Iwan Ariawan, Joy E. Lawn. (2009). Neonatal resuscitation in low-resource settings: What, who, and how to overcome challenges to scale up? IJGO 2009; 107: s47-64

5. Biomatech. Final Report; Cleaning and disinfection procedure validation according to the AAMI TIR technical report and NF EN ISO 17664 standard on the Silicone Suction Unit, reference part number 986000, batch 5/2010. July 01, 2010. France.

To suction To empty during suction To clean after suction

BACKGROUND

Actual need WHO estimates that nearly 1 million newborns in low and middle income countries die from birth asphyxia each year. A similar number are disabled due to inadequate breathing at birth.1 To stimulate spontaneous breathing, or perform

clearing the mouth and nose of mucous and meconium using vacuum.2,3

Current situationWhereas available neonatal suction devices available cannot be cleaned for reuse, budgets generally prevent single patient use.4

Meeting a challengeUN’s Millennium Development Goal No 4 (MDG 4) aims at reducing the mortality of children, including newborns, by 2/3 by 2015. To help reach the MDG 4 we have

safe to use, available at a low price and can be reused for multiple patients over a very long period of time. This device is also suitable for large scale training of birth attendants.

PRODUCT QUALITIES

Design • Ergonomic shape allows convenient one hand operation • Inviting non-clinical look as represented by a friendly penguin • Easy opening and closure in connection with emptying and cleaning • One-part design requires no disassembly/reassembly

Material• See-through silicone rubber permits immediate visual inspection of any suctioned matter• Can be cleaned in high temperatures by methods including boiling and autoclaving• Soft beak shaped nozzle will not hurt baby’s mouth and nostrils• Withstands aging and discoloring during storage over extended periods of time

Cleaning• for continued suction • After mechanical removal of debris boiling in water for 10 min. has been 5

• Meets recommendations of providing vacuum of up to 100 mmHG (136 cmH2O)

• Low purchase price and use for high numbers of patients over years make this suction device most suitable for general use in low income countries. •