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Drill Kit

Second Stage Fetal Bradycardia

Introduction

Step Up Together Drill Kits support interdisciplinary clinical teams to run emergency drills involving patient hand-offs and/or transport to a higher level facility.

Each Drill Kit can be used to run a Full Transfer Drill that tests the full, interdisciplinary process of care or a Partial Transfer Drill that involves running just one segment of the scenario (e.g. before transfer or after hospital hand-off). The toolkit includes a standardized high-fidelity case designed to test the process of transferring a birthing person or newborn from one location to another with an interdisciplinary team involved in the care. Observation criteria and a Debriefing and Action Guide are provided to elicit continuous improvement of interdisciplinary care processes and promote respectful care along the continuum.

Drill Description

This Drill Kit tests the emergency response to a second stage fetal bradycardia occurring in a community birth setting including emergency transport of an intrapartum patient.

It is appropriate for:

  • Home birth practices
  • Birth centers
  • Other facilities or units requiring patient transport for emergency surgery or stabilization (e.g. emergency department)

And may further engage:

  • EMS or other emergency transport partners
  • Labor & Birth unit and other relevant units at the referral hospital

To test the process of:

  • Intrapartum emergency transport

Learning Objectives:

  • Identify and respond to fetal heart rate abnormalities in the context of intermittent auscultation in planned community birth.
  • Review ways to promote person-focused care during emergencies.
  • Perform initial steps to attempt to resolve fetal bradycardia in the second stage of labor.
  • Identify need for higher level of care and initiate appropriate hospital transfer.
  • Practice collaboration that adheres to relevant transfer protocols with warm hand-offs across levels of care.
  • Communicate effectively, and with dignity, to the patient, support people, and additional healthcare personnel in the event of an intrapartum transfer.
Publish Data

Authored by:

Alexa Dougherty, MSN, PHN, CNM

Reviewed by:

Jen Johnson, MS, CNM
Amy Romano, MBA, MSN, CNM, FACNM
Laura Thielke, MS, CNM

Last updated: December 2024

Will you be coordinating a partial or full transfer drill?

Set up for the Step Up Together drills depends on whether you plan to run a Partial Transfer Drill or a Full Transfer Drill. Select which type of drill you will be coordinating and follow the instructions in the following sections.

Need help deciding which type of drill to run? Watch our video on Running Full or Partial Transfer Drills.

Partial Transfer Drill

What is it?

An emergency drill of a clinical scenario that requires transfer, but participants are only practicing part of the scenario: either the part that happens in the community before hospitalization, or the arrival at the hospital and post-transfer management.

Who's involved?

Minimum of two individuals from a practice, up to the full practice/facility, with or without collaborating partners present.

Planning Needs

Can be impromptu with a small group or scheduled in advance at regular times, for which participation should be compensated.

Full Transfer Drill

What is it?

An emergency drill of a clinical scenario that requires transfer and participants practice all phases of the transfer: care in the community, emergency transport, and arrival and management at the hospital.

Who's involved?

Full practice/facility team from the community birth setting, plus transport and hospital personnel.

Planning Needs

Requires coordination and advanced planning with community practice, EMS, and hospital teams. Compensate for time to participate.

Sign up to coordinate this drill.

Access everything you need to run a Second Stage Fetal Bradycardia drill.

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