Available online 19 September 2023, 151822

Author links open overlay panel, Abstract

Airway management is a fundamental component of neonatal critical care and requires a high level of skill. Neonatal endotracheal intubation (ETI), bag-mask ventilation, and supraglottic airway management are complex technical skills to acquire and continually maintain. Simulation training has emerged as a leading educational modality to accelerate the acquisition of airway management skills and train interprofessional teams. However, current simulation-based training does not always replicate neonatal airway management needed for patient care with a high level of fidelity. Educators still rely on clinical training on live patients. In this article, we will a) review the importance of simulation-based neonatal airway training for learners and clinicians, b) evaluate the available training modalities, instructional design, and challenges for airway procedural skill acquisition, especially neonatal ETI, and c) describe the human factors affecting the transfer of airway training skills into the clinical environment.

Section snippetsBackground

Airway management is a fundamental component of neonatal critical care and requires a high level of technical skill, even for anatomically normal airways.1 Compared to older age groups, the neonate's unique anatomy and physiology, specifically including laryngeal hyperexcitability, ventilatory depression with hypoxia, and low respiratory reserve (short interval between apnea and desaturation), present challenges for the clinician.1,2 Neonatal airway management includes technical skills such as

Conclusion and future directions

The optimal training model for neonatal airway management remains to be determined and will likely need to be individualized to each learner. Learners of different experience levels respond differently to training modalities. There is probably no universal training method that fits all, and it may be necessary to use multiple methods to cover all aspects of airway management.

In the future, various approaches are needed to improve training outcomes, and ultimately patient safety. Further

Declaration of Competing Interest

Dr. Soghier is the co-editor of the Neonatal Simulation book and receives royalties from the American Academy of Pediatrics. She is also funded by the NICHD 1R01HD091179-01 for developing computerized assessment tools for neonatal intubation. Dr. Yousef has served as a consultant and lecturer and has received grants and honoraria from Chiesi Pharmaceuticals. She has also served as a consultant for Radiometer Medical Aps. These companies have had no role in the manuscript's design, preparation,

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