Effect of Warmer Height (Standard versus Custom) on Neonatal Chest Compression Performance: A Cross-Over Simulation Study

This study aimed to evaluate whether a custom warmer height improves the quality and consistency of chest compressions (CCs) compared with a standard warmer height during simulated neonatal resuscitation.Cross-over study using simulated neonatal resuscitation. A controlled research environment equipped with a 12-camera motion capture system, four in-floor multi-axis force plates, a neonatal manikin, and resuscitation equipment. Biomechanical assessments were recorded every 2 minutes during a 20-minute simulation for each condition. Twenty Neonatal Resuscitation Program (NRP)-trained providers. Each participant performed two 20-minute CC sessions-one with the warmer at the standard 100 cm height and one at a custom height selected by the participant. CC depth, force, and rate; participant back angle, heart rate, and self-reported exertion, were analyzed at 2-minute intervals.Compared with the standard height, the custom height resulted in greater and more consistent CC depth and force while maintaining compression rate. Participants also exhibited a greater back angle, and lower heart rate, and reported reduced exertion under the custom height condition.Allowing NRP-trained providers to adjust warmer heights led to improved CC quality and consistency, suggesting that customizable warmer heights may enhance neonatal resuscitation performance. KEY POINTS: · Custom warmer height chosen by NRP-trained providers resulted in more consistent and greater CC depth and force.. · It also was associated with less provider fatigue, compared with standard height.. · During neonatal resuscitation, frontline healthcare professionals changed.. · Participant heart rate was lower when using the custom versus standard height.. · Our findings support the need for guidelines on adjusting warmer height during neonatal cardiopulmonary resuscitation..