G567(P) Exploring paediatric trainees' experience and training in neonatal airway management skills. (25th October 2020)

• Record Type: Journal Article
• Authors: Belkhatir, K; Scrivens, A; O'Shea, J; Roehr, C
• Is Part Of: Archives of disease in childhood. Volume 105(2020)Supplement 1
• Page Start: A203
• Page End: A203
• Publication Date: 2020-10-25
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-rcpch.485
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Effective and timely airway management is crucial to successful neonatal resuscitation. Successful airway management requires training and maintaining ongoing experience, as well as a unique set of skills and equipment appropriate for the neonatal population. Level 1 trainees are required by the Royal College of Paediatrics and Child Health (RCPCH) to undertake 'advanced airway support, including tracheal intubations'. However, trends towards non-invasive respiratory support, fewer opportunities to practice at the workplace and lack of training have hindered the acquisition of these important procedural skills. Aims: To understand the experience and training of paediatric junior doctors and Advanced Neonatal Nurse Practitioners (ANNPs) in neonatal airway management skills, with a particular focus on neonatal intubation, use of videolaryngoscopy and laryngeal mask airways (LMA). Methods: An online survey was sent to trainee paediatricians and ANNPs in the UK and Ireland via deanery tutors, trainee representatives and the British Association of Perinatal Medicine (BAPM). Respondents reported their experience and training in neonatal intubation and LMA use. Results: The survey received 705 responses. Of these, 196 were junior trainees (ST1-3), 404 were senior trainees (ST4-8), 74 were ANNPs, 31 were clinical fellows. Experience levels were reported as: 42 (6%) no experience of intubation, 291 (41%) <5 term intubations and 235 (33%) <5 preterm intubations. 65% of respondents reported never receiving neonatal intubation training. Videolaryngoscopy is used mainly for difficult airway management (27%); only 7% prefer its use in neonatal intubation. 44% of respondents have had training in using LMAs in neonates, but only 6% have used it on a newborn infant. 70% of trainees strongly felt that a structured training programme would help them to become more confident in neonatal airway management. Conclusion: An alarmingly small number of paediatric junior doctors and ANNPs have formal neonatal intubation/LMA placement teaching, or exposure to practical experience. Developing effective strategies to train paediatric trainees in neonatal airway management is important. Videolaryngoscopy offers a powerful educational means for real-time coaching and teaching neonatal intubation.