LAUSR

Background and aims Based on the model of care for neonatal services in Ireland 2015, Cavan General Hospital is classified as a level 1 local unit. Therefore it offers routine and special care to infants ≥32 weeks gestation. Infants ≤32 weeks should usually be transferred to a regional/tertiary unit, preferably in-utero, however this is not always possible. Currently there is no national/local guideline in place to indicate which paediatric staff should be called routinely to attend premature deliveries.The aim of this audit was to establish who currently attends premature deliveries. Also to explore what would be best-practice in a level 1 unit like Cavan and make appropriate recommendations. Methods A retrospective chart review was carried out of all premature deliveries ≤32 weeks gestation over a 3 year period from 2012 to 2014. Data such as mode of delivery, indication for delivery, members of the resusitation team in attendance and use of steroids were recorded and analysed. Results In total, 27 deliveries were reviewed, 12 vaginal deliveries and 15 Emergency Cesarean Sections. Based on gestation; < 26/40: (n=3), 26–30/40: (n= 7), 30–32/40: (n=17).Abstract P181 Table 1 Members of Neonatal Resusitation Team present at ≤32/40 weeks gestation deliveries All in Attendance (Consultant, Reg, SHO, SCBU Nurse) 3 Reg & SCBU Nurse 8 Consultant,Reg, SCBU Nurse 4 Reg Alone 4 Consultant, Reg, SHO 3 Reg, SHO, SCBU Nurse 2 Consultant & Reg 1 Reg & SHO 1 Consultant Alone 1 The Paediatric Registrar was present at 26/27 (96%) of deliveries, a SCBU Nurse at 18/27 (66.6%), the Paediatric Consultant at 12/27 (44%) and the Paediatric SHO only documented at 9/27 (33.3%). Of note a paediatric consultant attended all 3 deliveries <26/40 and 6/7 deliveries between 26–30/40. Conclusion In our small cohort, there was wide variation with noconsistent practice. Resusitation documentation needs improving. A SCBU Nurse and Paediatric Registrar were the commonest resuscitation team. Deciding on a gestational cut off and defining high-risk deliveries would be helpful in establishing a standardised protocol for when a consultant paediatrician should be in attendance at a delivery.