During an eight-day instruction period, the Tennessee Perinatal Regional Center at Monroe Carell Jr. Children’s Hospital at Vanderbilt coordinated with the Nashville Fire Department to train 493 paramedics and emergency medical technicians in neonatal resuscitation practices to become Neonatal Resuscitation Program (NRP) providers.
Led by Mary Lee Lemley, MSN, RNC-NIC, neonatal outreach manager, along with neonatal outreach coordinators Katie Judd, MSN, RN, CCRN-Neonatal, and Meghan Arms, MSN, RN, RNC-NIC, this three-person team collaborated with Vanderbilt LifeFlight to organize an intensive interactive program. Each day, 50 to 60 Nashville Fire employees participated in four-hour sessions, beginning with lectures on best neonatal practices for resuscitation, followed by hands-on group exercises facilitated by LifeFlight instructors.
At the conclusion of each session, participants underwent a review process to assess their competency and complete the requirements for the NRP.
“The teamwork between LifeFlight, our team and Nashville Fire was tremendous. The crews were invested and quickly grasped this new and critical skill set,” said Lemley.
This partnership program is part of a broader initiative aimed at educating and certifying staff across Tennessee in neonatal resuscitation. The need is urgent: Out of 95 counties in the state, 54 are considered maternal deserts, which by definition are areas that do not provide obstetric care.
As a result, emergency medical service (EMS) personnel are increasingly involved in deliveries, often without the necessary training to support newborns in taking their first crucial breaths.
Recognizing the gap, Monroe Carell, one of the five Tennessee Perinatal Regional Centers, sought solutions to improve neonatal resuscitation efforts.
“As maternity deserts continue to expand across the state and nation, we are heavily reliant on the skill set of emergency medical workers in the field,” Lemley said “They recognize the importance of the first few minutes of life and the vital role they play in supporting newborns as they transition. With EMS in Tennessee being 19,000 strong, we felt it was imperative to ensure they had the latest information in neonatal resuscitation.”
While EMS personnel are required to be certified in adult and pediatric resuscitation, neonatal-specific training is not currently mandated.
“Neonatal resuscitation is different from pediatrics. When a newborn baby is separated from their mother, ventilating them quickly and properly is so important,” Lemley said.
With support from a grant provided by the Tennessee Department of Health and TennCare, the outreach team is working to certify existing and new EMS personnel statewide through the NRP.
Through expanded partnerships with the Center for Programs in Allied Health at Vanderbilt University Medical Center, Volunteer State Community College, Motlow State Community College and Columbia State Community College, they’re ensuring all graduating EMS personnel receive neonatal resuscitation training.
Within just one year, the Monroe Carell neonatal outreach team has successfully increased the percentage of EMS NRP providers in middle Tennessee from 3% to 33%.
“We’ve established a footprint, but there’s still a long way to go,” Lemley remarked.
Looking ahead, the team aims to extend neonatal resuscitation education to other community roles, including state troopers, park rangers and anyone who may unexpectedly encounter emergencies involving newborns.
“In emergency situations, we can’t always control the outcomes, but we owe it to our most fragile patients to give them the greatest chance of survival,” Lemley said. “As educators, our commitment is to deliver the best training possible to those individuals on the frontlines.”
