Technical realization of a sensorized neonatal intubation skill trainer for operators' retraining and a pilot study...

Area of Science:

• Medical Simulation
• Pediatric Anesthesiology
• Neonatal Care

Background:

• Excessive pressure during neonatal endotracheal intubation can cause permanent injury.
• Existing low-fidelity trainers lack valid feedback mechanisms for tissue pressure.
• This study introduces an active neonatal intubation skill trainer with objective feedback capabilities.

Purpose of the Study:

• To technically realize and validate an active neonatal intubation skill trainer.
• To provide objective, real-time feedback on applied pressure during simulated neonatal intubation.
• To assess the trainer's effectiveness in improving procedural technique and reducing trauma risk.

Main Methods:

• Commercial force sensors were integrated into a Laerdal Neonatal Intubation Trainer, simulating a difficult intubation (Cormack and Lehane grade 3).
• An associated software provided real-time auditory feedback when pressure exceeded predefined thresholds.
• Participants underwent two intubation sessions with a 24-hour interval, including debriefing and interviews to gather performance and design feedback.

Main Results:

• Statistically significant learning trends were observed, with pressure on critical points (epiglottis and dental arches) decreasing significantly between sessions (p < 0.0001).
• The epiglottis sensor registered the highest stress.
• A significant inverse correlation was found between attempt duration and applied pressure, particularly in the second session (rS = 0.603).

Conclusions:

• The developed skill trainer serves as a reliable model for difficult neonatal intubation scenarios.
• The trainer has the potential to optimize procedures by controlling trauma risk.
• It offers a valuable tool for improving healthcare personnel retraining in neonatal intubation.