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Managing Birth Asphyxia

Team Members:
  • Stephen Dria
  • Kaitlyn Harfmann
  • Christopher Lee
  • David Narrow
  • Janine Bullard, MD
  • Helge Myklebust
  • Harshad Sanghvi, MD
  • Day of Birth Alliance
  • Jhpiego
  • Laerdal Global Health


Annually, there are over 4 million global neonatal deaths primarily occurring in resource-constrained environments. This accounts for over 38% of deaths in children under the age of five. When performed properly, neonatal resuscitation is an effective means to revive newborns that are unable to properly breathe. Statistics indicate that birth asphyxia accounts for 23% of all neonatal deaths. Additionally, another one million newborns suffer from permanent disabilities due to insufficient oxygen at time of birth. Effective newborn resuscitation alone can prevent millions of newborn deaths.Neonatal resuscitation requires the use of a ‘bag-valve-mask’ or BVM. The BVM channels ambient air from the atmosphere into a one-way valve, when the user compresses the bag-component. Gas is then expelled through the mask and into the trachea, bronchus and lungs of the infant. Due to the technical difficulties associated with the procedure, newborns that otherwise would have been resuscitated die because of ineffective equipment operation and improper technique—a function of the burden of training and skill retention. Thus, it is critical to reduce the amount of skill required for providing an effective and consistent resuscitation, especially in peripheral health care centers of the developing world.

Failed resuscitations are attributed to poor head positioning and an inadequate seal between the mask and the baby’s mouth. However, air is forcibly pushed into the lungs through ventilation only; when proper mask seal and head positioning are addressed together. After significant research, chest rise is a variable that is most cost-effective to quantify successful resuscitation instantaneously. Thus, a tool to quantify lung expansion would be revolutionary to the resuscitation protocol, providing low-skilled health workers real-time feedback throughout the procedure. Our innovation will mitigate existing inadequacies attributed to constrained resources, diminished skill retention over time and difficulty using devices associated with resuscitation. Our technical solution quantifies chest expansion and guides the user through a proper resuscitation, improving the results of attempted resuscitations and successfully managing birth asphyxia.

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