Course equipment
Equipment items that are used in NCPR courses are indicated below.

•Resuscitation table (optional)- Radiant warmer①

It is highly effective to hold an NCPR course using an actual radiant warmer(Photo: ①). A radiant warmer equipped with a switch for keeping warm,
aspirator, oxygen blender, and timer makes it possible to perform the simulation
in a more realistic environment. Note that it is difficult to carry a radiantwarmer into some course halls and that some facilities have rules not touse equipment for their regular operations in a seminar. The organizer must
confirm, in advance, whether a radiant warmer and other clinical devices may
be used.
- Resuscitation training table②

When no actual radiant warmer can be used, we recommend placing a simplified
resuscitation table (Photo: ②) on a meeting table.
It is possible to put a neonatal resuscitation model directly on a meeting table fortraining. However, it is preferable to use a simplified table with legs that adds aheight of approx. 5 cm (Photo: ③) because a meeting table is lower than an actual
resuscitation table.

③•Neonatal resuscitation model- Radiant warmer①②

A neonatal resuscitation model (Photo: ①) accurately simulates the constitution,body surface, oral cavity, airway, respiratory tract, and other anatomical
structures of a neonate. A model is carefully produced so that the rib cage
moves synchronous to appropriate positive pressure ventilation, that adequate
resilience is felt during chest compression, and that landmarks for tracheal
intubation can be correctly understood.
Using a neonatal resuscitation model, it is possible to perform a highly realistic
simulation that is close to the actual neonatal resuscitation procedures,including the opening of the airway, artificial respiration, chest compressions,and tracheal intubation. The NCPR courses are held with a focus on simulation
training using an accurate neonatal resuscitation model. There is also a highly
functional simulator that expresses heartbeat, breathing, skin color, cries, andother factors through remote control and keeps a log of the scenario programas seminar records (Photo: ②).

-1-•T-piece resuscitator- T-piece resuscitator (to be used for Continuous Positive Airway Pressure (CPAP)①②③

After the initial procedure for resuscitation is completed, when spontaneous
respiration exists with a heart rate of 100 per minute or higher, and bothforced breathing and central cyanosis are recognized, we recommend applying
Continuous Positive Airway Pressure (CPAP) at first using the air.
Using a T-piece resuscitator(Photo: ①,②), it is possible to adjust the endexpiratory airway pressure on the dial at hand (i.e. on the patient side)
while setting the Peak Inspiratory Pressure (PIP) on the resuscitator dial.
This device makes it possible to set inspiratory pressure and end-expiratory
airway pressure required for artificial respiration to pre-specified levels. The
timing of expiration is also easily performed by controlling the valve with theresuscitator’s thumb.
This device has the advantage that it allows anyone to perform artificial
respiration because the resuscitator can be concentrated on the adherence ofthe mask. On the other hand, this device also has the disadvantages that a gas
supply is needed, that it is not effective when there is a large leak around themouth, just as in the case of ordinary artificial respiration, and that it is difficult
to feel pulmonary compliance with this device. Recently, a disposable T-piece
circuit that does not require a respirator has also become available (Photo: ③).

•Neonatal resuscitation bag- Self inflating bag①②

A self-inflatable bag (Photo: ①) has the advantage that the bag naturally
inflates to the original size without connecting to a gas supply. The bag inflates
even if the mask is loosely attached, thereby enabling the resuscitator tocontinue artificial respiration.
Because a relief valve is attached, the risk of applying excessive pressure isalleviated. On the other hand, this type of bag has the disadvantage that itis difficult for the resuscitator to recognize when artificial respiration is noteffective. Therefore, the resuscitator must confirm whether artificial respiration
is being performed adequately. A reservoir is required to use high-concentration
oxygen. Recently, a bag with a PEEP valve (Photo: ②) has also become available
that allows the setting of end-expiratory airway pressure. As the capacity of aresuscitation bag, 500 mL is recommended for a full-term neonate.
- Flow-inflating bag①②

A flow rate-inflatable resuscitation bag (Photo: ①) has the advantage that it
is capable of ventilation at the oxygen concentration directly fed by the gas
supply. When a blender is used, it is possible to perform artificial respiration
directly at the oxygen concentration specified by the blender. This type of bag
also enables free-flow oxygen delivery. A well-experienced resuscitator can feelthe pulmonary compliance of the baby through the bag.
This type of bag also enables mask CPAP. The disadvantages are that thebag does not inflate unless the mask is tightly attached to the baby and thatmost marketed models are not equipped with a relief valve, among otherweaknesses. To perform artificial respiration at an appropriate inspiratory
pressure, it is essential to use a manometer (Photo: ②). As the gas flow to beconnected, 5 to 10 L per minute is considered appropriate.
-2-•laryngoscope- laryngoscope (for use with neonates)①

Usually, a laryngoscope for a neonate has a direct blade (Miller type or WisHipple type) and is of size 00, 0, or 1. While some marketed models do not offer
size 00, size 0 or 1 is considered sufficient for handling mature newborns only.
The respective shapes of blade and grip slightly vary by product and can be
freely selected according to the user’s choice.

•air pump- air pump①

The course program includes an artificial respiration exercise using a flow
rate-inflatable bag. When the seminar is held in a hall that does not have a gas
outlet, an air pump (Photo: ①) is required to drive the gas supply. The maximum
flow rate should be 10 L per minute or higher. It becomes possible to check thegas flow rate during the exercise when an oxygen flow meter (a humidifier isnot necessary) is used in combination.

•Oxygen flowmeter and blender- Air-oxygen blender①

Consensus2010 recommended adjusting the oxygen concentration to the baby’sstatus. This recommendation is maintained in Consensus 2015. While it isessential to use a blender (Photo: ①) in the resuscitation practice, it is difficult
to hold a seminar using an air-oxygen blender unless the NCPR seminar hall isequipped with a medical gas outlet. The high price of a blender also makes it
difficult to prepare one for a course.
In place of a blender, what about making and using a simulated blender?
It would be a good idea to use a handmade simulator that consists of anadequate paper box and a simulated dial and oxygen concentration scale(Photo: ②).

②-3-•Pulse oximeter- Oxygen saturation meter
Consensus 2010 recommended the use of a pulse oximeter (Photo: ①) to objectively evaluate a baby that
requires neonatal resuscitation.
It is considered essential to use a pulse oximeter from the perspective of avoiding excessive oxygen delivery.
This recommendation is maintained in Consensus 2015. In the Instructor Training Course, a specially designedpulse oximeter simulator (Photo: ②) is used.
In general courses, it would be sufficiently effective to use a disposable SpO2 sensor in combination with flipcharts that indicate heart rate and SpO2 value (Photo: ③).
There is also a simplified simulator (Photo: ④) developed by the NCPR Committee.

①②③④•ECG monitor- ECG monitor①Consensus 2015 suggest an examination of the use of an ECG monitor for ababy that requires artificial respiration. It facilitates the determination of acorrect resuscitation policy to evaluate the baby’s heart rate more accurately
and more objectively. Some highly functional simulators produce heartbeatsand express an ECG on a separate monitor. However, such a highly functional
simulator is extremely expensive and not for general use. In a seminar using anormal neonatal model, it would become necessary to express the heart rateusing flip charts or other tools after attaching ECG electrodes (Photo: ①) to theneonatal model.

•Algorithm Chart•consumables strage bag- Algorithm Chart- consumables strage bag

The Algorithm Chart(Photo: ①) is sold by the
JSPNM (NCPR ProjectOffice). We recommend
attaching this chart
to a panel and using
an easel to put it in aposition that is easily
visible to participants(Photo: ②).

Various consumables
need to be used in acourse. It takes timeand energy to takethem out of individual①boxes and lay them outon a table. A storage bag with exclusive pockets(Photo: ①) allows you to identify each item at aglance and saves much energy.

①-4-•Consumables
Sizes

Name

Manufacturers (reference)

Remarks

Suction Catheters

12Fr
10Fr
8Fr
6Fr

Terumo, etc.

Suction bulb syringe

Large
Small

Atom Medical, etc.

Face mask

Large (for a neonate)
Small (for a neonate)

Atom Medical, AMBU,
etc.

Anatomical shape

Endotracheal tubes

3.5mm
3.0mm
2.5mm

Covidien, Terumo, etc.

Cuffless

Stylet2.5mm or more
2.0mm or more

Smiths Medical,
InterMedStandard type
Ultrafine typeEnd-tidal CO2 detectorPedi cap
Ministat cap

Covidien, MPI

Umbilical vein catheter

5.0Fr

Covidien

stethoscope

For neonates

3M Littmann, etc.

Feeding tube

6.0Fr

Atom Medical, JMS, etc.

Syringe (cathetip)

1.0ml
2.5ml
5.0ml
10.0ml20.0ml30.0ml50.0mlJMS, etc.

Syringe (general-purpose)

1.0ml
2.5ml
5.0ml
10.0ml20.0ml30.0ml50.0mlTerumo, Nipro, etc.

General purpose

SpO2 sensor
Probe for neonates

For neonates

Masimo, Nihon Koden,
Covidien, etc.

Disposable (with a cable)

ECG electrodeFor neonates

Adhesive plaster

Width: 1.0 cm

3M

General purpose

Bath towel

Two sheets

General purpose

Face towel

Two sheets

General purpose

Laryngeal mask away

For neonates

Intersurgical, etc.

-5-PVC-freeCathetip type with a contrast
medium line, misconnection-proof