Nov 15
Blog: Simulations that Save Mothers and Babies

Through the generosity of The Flower and Fruit Mission, Saratoga Hospital received a Noelle® comprehensive teaching system, complete with mannequins, to simulate the full birthing experience before, during, and after delivery for training and drilling purposes. 

“As regulations change or new protocols develop, these simulations give us the opportunity to learn, teach, and practice them before we must use them in the field,” says obstetrician Amos Cutler, MD, Vice Chair of the department of OB/GYN at Saratoga Hospital. “At the time of the donation, certified instructors in the area had limited availability, but we didn’t let that stop us. Saratoga Hospital flew four of us to Florida to take the course, and we’ve been training since then. I enjoy teaching, very much, and our childbirth simulation program gives me the opportunity to teach quarterly.”

Certified Childbirth Educator Kim Kenyon-Berry, MSEd, BSN, RNC-OB, is one of Saratoga Hospital’s Neonatal Resuscitation Program® and childbirth simulation instructors. She says both the Noelle® and baby Hal mannequins have greatly prepared physicians and staff to handle numerous emergencies, such as postpartum hemorrhage, prolapsed umbilical cords, and shoulder dystocia—when the baby’s head is out but the shoulders are stuck.

“The simulations are set to be as real as possible,” Berry says. “Hal, the infant mannequin, can stop breathing and even turn blue as we go through neonatal resuscitation drills. The more we do them, the faster and more comfortable our team can be. Hal is smaller and easier to set up, so we try to add as many unscheduled trainings with him as we can on top of the scheduled ones.” 

Dr. Cutler says successfully delivering a baby in shoulder dystocia can be a challenging maneuver, especially as it is better in such cases to deliver the baby within four minutes. 
“The simulation gives our team members the opportunity to practice that,” he says. “With the Noelle®, we simulate the doctors’ and nurses’ role at every step. Then we debrief on what we’ve learned, such as recognizing the signs and discussing what we could do differently. Most of the time, you cannot anticipate emergencies, but these simulations help us explore and be ready for the possibility.”

Postpartum hemorrhage drills include several departments in the hospital as well as OB/GYN, such as emergency department and intensive care nurses, lab technicians, and care managers.

“We need all those departments involved when it’s a severe postpartum hemorrhage,” Berry says. “I’ve been doing this for 32 years, and these cases have become more frequent—up to as many as one or two a month. Women with chronic hypertension, diabetes, obesity, and who smoke are at a higher risk, and these simulations keep us prepared. As a hospital, we’re participating in the New York State Department of Health Managing Maternal Hemorrhage project. Saratoga Hospital is among those leading the way in identifying risk factors prior to delivery. These procedures and drills are lifesaving.”

One of the specific cases Dr. Cutler will always remember is a time when he was called in to assist a colleague with a patient experiencing postpartum bleeding. “I’m driving in to the hospital thinking, this is her first pregnancy and the last thing I want to do is a hysterectomy,” says Dr. Cutler. “Fortunately, we had just had a Noelle® simulation on postpartum hemorrhage the week before, where we learned about using the Bakri Balloon medical device, which can temporarily control bleeding.”

Use of the Bakri device is a simple procedure, involving inflating the device with saline, which puts pressure on the uterus and halts the bleeding. 

“It worked,” Dr. Cutler says. “Mother and baby were perfectly fine. Over the years, she had three more successful deliveries. I have been delivering babies for nearly 30 years, and they are all memorable, but this moment reminds me how important it is to never stop learning. Regular, ongoing training is a necessary part of doing our best for our patients, and we are all grateful to The Flower and Fruit Mission for this lifesaving donation.” 

Dr. Cutler practices at Saratoga OB/GYN at Myrtle Street. Kim Kenyon-Berry is a member of the hospital’s maternity team at William J. Hickey Women’s Health Services. To learn more, please visit Obstetric and Gynecologic Care at Saratoga Hospital.

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