Responses

Download PDFPDF
Simulation in shoulder dystocia: does it change outcomes?
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses [https://authors.bmj.com/after-submitting/rapid-responses/].
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses [https://www.bmj.com/company/journals-terms-and-conditions-for-rapid-responses/] and understand that your personal data will be processed in accordance with those terms and our privacy notice [https://www.bmj.com/company/your-privacy/].
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Shoulder Dystocia Simulation Can Change Outcomes
    • Edith D, Gurewitsch Allen, Professor and Executive Vice Chair, Obstetrics & Gynecology and Women's Health Einstein School of Medicine, Montefiore Hospital
    • Other Contributors:
      • Robert H Allen, Assistant Research Professor, Dept of Obstetrics & Gynecology and Women's Health

    We congratulate Kim et al on developing a shoulder dystocia training program that included video instruction, a didactic portion and a simulation training session including force measurement, followed by a study aimed at evaluating the impact of the training on actual clinical outcomes.1 Their observed two-fold increase in shoulder dystocia incidence is consistent with some other studies,2, 3 and more in line with prospective clinical studies that report an incidence of ~ 4% among term vaginal deliveries.4, 5 It further suggests improved recognition of shoulder impaction in the final stages of delivery in the clinical setting following simulation-based training.

    Ultimately, the patient safety goal of shoulder dystocia simulation training for should be the reduction in shoulder dystocia-associated brachial plexus injuries. We would be interested to learn if there was a higher correlation between brachial plexus injuries and shoulder dystocia after training than before.

    Compared to other force training studies, Kim et al did not find a similar decrease in brachial plexus injuries.6-8 We offer a hypothesis as to why that might be.

    We believe that demonstrating what 100 N feels during simulation, even with admonishing the trainee not to use that much traction, is not effective at reducing injury. One reason is that memory of that much traction once experienced is short-lived, and clinicians tend to underestimate the traction they apply during a difficu...

    Show More
    Conflict of Interest:
    None declared.