An active simulator for neonatal intubation: Design, development and assessment.

Area of Science:

• Medical Simulation
• Biomedical Engineering
• Pediatric Medicine

Background:

• Neonatal intubation is a critical procedure requiring precise skills.
• Objective feedback is crucial for improving clinical competence in neonatal intubation.
• Existing training tools may lack detailed, objective performance metrics.

Purpose of the Study:

• To technically realize and pre-clinically validate an instrumented neonatal intubation skill trainer.
• To provide objective feedback on force application and technique during neonatal intubation.
• To enhance clinical competences for neonatal intubation through improved training.

Main Methods:

• Modification of a Laerdal Neonatal Intubation Trainer with pressure sensors (FSRs) on key anatomical areas.
• Integration of a custom silicone tongue with a matrix textile sensor for pressure mapping.
• Assessment by nine clinical experts performing three intubation procedures each, measuring forces and execution time.

Main Results:

• The epiglottis experienced the highest stress during intubation (median 3.11N, max 16.69N).
• Pressure distribution on the tongue provided insights into clinician performance and force application.
• Objective data on force, over-threshold events, and time were collected for each trainee.

Conclusions:

• The instrumented trainer effectively provides objective feedback for neonatal intubation skills.
• The tool enhances clinician awareness of applied force and gestures, aiding skill optimization.
• This validated trainer serves as a foundation for improving neonatal intubation competency for all levels of clinicians.