regarding not only cerebral but abdominal or renal tissue oxygenation (rSO2) as well. Fractional tissue oxygen extraction (FTOE) is calculated from NIRS measurements and arterial haemoglobin oxygen saturation (SpO2) measured by pulse oxymeter. Multichannel NIRS devices maybe very helpful in newborns with multisystem problems enabling realtime simultaneous measurements of rSO2 from different parts of the body. Pulse oxymeter integrated into a multichannel NIRS device provides simultaneous SpO2 monitoring making FTOE calculations more accurate and easier. Methods Three term newborns; 2 undergoing therapeutic hypothermia for hypoxic ischaemic encephalopathy grade II, 1 with critical pulmonary stenosis before and after cardiac surgery were monitored by multichannel NIRS (Sensmart X-100, NONIN, USA) device including cerebral, abdominal, renal rSO2 and SpO2 probes. FTOE was calculated using the equation; (SpO2-rSO2)/SpO2. Results Duration of monitorization and rSO2 and FTOE values of different body sites are presented in table with mean±SD. Discussion Longterm simultaneous monitoring of tissue oxygenation in brain, abdomen and kidneys is useful while following newborns with multisystem problems requiring hypothermia or circulatory medications to titrate the treatment accordingly. NIRS device with integrated pulse oxymeter maybe helpful for realtime calculation of FTOE to assess hemodynamics.

Aims Neonatal trainees are infrequently exposed to chest drain insertion due to reduced working hours and low prevalence of pneumothoraces. Procedure performance assessment during simulation using cadaveric models is more effective than traditional clinical education methods. We aimed to evaluate the efficacy of simulation training in teaching PCCD insertion using rabbit carcasses on a tertiary neonatal unit (NICU), in terms of both meeting British Thoracic Society (BTS) competencies and improving participant’s procedural confidence and knowledge. Methods This is a prospective observational study, including advanced neonatal nurse practitioners (ANNPs), nurses and doctors on a NICU. Teaching included a lecture, video and simulation training in small groups using rabbit carcasses. Questionnaires were given to all participants before and after the teaching and simulation sessions. The questionnaires evaluated both knowledge and participants’ self-evaluation of confidence at inserting, or in the case of the nurses, assisting in inserting PCCD using a 5-point Likert-scale. After simulation teaching, insertion technique was observed by faculty and compared with a checklist based on BTS. All data were represented as median (range) and analysed using Wilcoxon signed rank; significance was assumed when p < 0.05. Results 20 datasets were collected, 15/20 were completed sufficiently for full analysis. Postgraduate experience of participants ranged from 3–39 years (median 9.5). 7/20 had previous experience of inserting straight catheters, ranging from 1–50 insertions (median 10) and 3 had previously inserted PCCD (median 3, range 2–10). 10 had no previous experience with any type of neonatal chest drain and 25% had previous teaching. 100% of participants agreed that the teaching was effective and that all session elements were useful to their learning (n = 20). After the simulation training the self-assessment scores of confidence (n = 15) improved from a median score of 1 to 5 (p < 0.001). Knowledge scores (n = 18) improved from a median of 7 to 8 (p < 0.001). 100% of participants assessed (n = 14) were able to meet local standards based on those from the BTS. Conclusion Using simulation training of pigtail catheter insertion with rabbit carcasses allows ANNPs, doctors and nurses working on a NICU to confidently attempt to insert or assist in the insertion of PCCD.