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G139(P) Advanced neonatal emergencies: confidence and experience levels of new registrars
  1. JM Parasuraman
  1. Paediatrics, Severn Deanery, Taunton, Somerset, UK

Abstract

Aims Paediatric trainees, who step up to the role of registrars at ST4/5 levels, are required to be competent in neonatal emergencies. Some of the competencies as highlighted by the RCPCH curriculum for level 2 are:

  1. Ability to lead initial and advanced resuscitation when required

  2. Ability to intubate pre-term babies without supervision

  3. Understanding of the principles and ability to initiate mechanical ventilation

  4. Ability to perform needle thoracocentesis for management of pneumothorax

These factors are especially important out of hours, when Consultants are non-resident. The aim of this project is to establish the current level of knowledge and skill set of ST4/5 trainees in the South West region. This information was acquired as part of the process to set up advanced neonatal simulation training within the region.

Methods A 10 questions survey was sent to the ST4/5 paediatric trainees in the South West region. To improve number of responses, the survey was sent through the respective deaneries and posted on the region’s paediatric social media page. The survey was carried out for a period of 45 days (October to November 2014).

Results Responses were obtained from 12 trainees (ST4:7, ST5:5) and the key results are listed below:

  1. Confidence in mechanical ventilation strategies: Only 41% of trainees stated that they were confident, with the rest either having confidence only with Consultant support or not confident.

  2. 50% of trainees have intubated < 5 term or preterm babies without supervision.

  3. 83% of trainees have never performed emergency needle thoracocentesis independently.

  4. 91% of trainees have never led an advanced resuscitation leading to withdrawal of care on the resuscitaire.

  5. 100% of trainees agreed that simulation training on advanced neonatal emergencies would add value to their skills and knowledge.

Conclusion New paediatric registrars are expected to be competent in advanced neonatal emergencies and procedures. Despite this, a high proportions in the survey lack experience and confidence in independent management and procedural skills for such scenarios. Training through neonatal simulation is vital to address these training needs.

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