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Published on: March 18, 2019
Impact of visual distraction on neonatal mask ventilation: a simulation-based eye-tracking study.
Katharina Bibl1, Michael Wagner2, Robyn Dvorsky2
1Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria katharina.bibl@meduniwien.ac.at.
Distractions during simulated neonatal resuscitation significantly worsen mask leak and reduce minute volume during positive pressure ventilation (PPV). Trainees also shift visual attention away from the infant when faced with multiple tasks.
Area of Science:
- Medical Simulation
- Neonatal Resuscitation
- Human Factors Engineering
Background:
- Effective positive pressure ventilation (PPV) is critical for neonatal resuscitation.
- Distractions are common in clinical settings and may compromise performance.
- Understanding the impact of distractions on PPV is essential for improving training and patient outcomes.
Purpose of the Study:
- To investigate the effect of simulated distractions on mask leak and visual gaze patterns during neonatal resuscitation.
- To assess how common resuscitation tasks influence ventilation parameters and trainee attention.
Main Methods:
- An observational, simulation-based study using a newborn manikin.
- Participants (medical students and paediatric residents) performed PPV under various distraction scenarios.
- Ventilation parameters (mask leak, minute volume, respiratory rate) were monitored using a respiratory function monitor.
- Eye-tracking glasses were used to record visual gaze patterns.
Main Results:
- Statistically significant increases in mask leak (31.0% vs 15.9%) and decreases in minute volume (202.0 vs 253.0 mL/kg/min) were observed during distractions.
- Participants showed significant gaze shifts from the infant to equipment and other tasks when distractions were present.
- Trainees self-rated performance lower during venous blood gas interpretation and generally overestimated their ventilation quality.
Conclusions:
- Distractions significantly impair positive pressure ventilation effectiveness during simulated neonatal resuscitation.
- Visual attention is diverted from the infant to other tasks when multiple demands are present.
- Simulation-based training should incorporate strategies to mitigate the impact of distractions on neonatal resuscitation performance.
