We observed statistically significant improvements in microvascular function, peak heart rate, and body composition. An adapted Nordic diet might improve microvascular health.

Ventilator-associated pneumonia is the most common healthcare-associated infection in mechanically ventilated patients. Despite this, accurate diagnosis of ventilator-associated pneumonia is difficult owing to the variety of criteria that exist. In this prospective national audit, we aim to quantify the existence of patients with suspected ventilator-associated pneumonia that would not be detected by our standard healthcare-associated infection screening process. Furthermore, we aim to assess the impact of tracheostomy insertion, subglottic drainage endotracheal tubes and chlorhexidine gel on ventilator-associated pneumonia rate. Of the 227 patients recruited, suspected ventilator-associated pneumonia occurred in 32 of these patients. Using the HELICS definition, 13/32 (40.6%) patients were diagnosed with ventilator-associated pneumonia (H-posVAP). Suspected ventilator-associated pneumonia rate was increased in our tracheostomy population, decreased in the subglottic drainage endotracheal tube group and unchanged in the chlorhexidine group. The diagnosis of ventilator-associated pneumonia remains a contentious issue. The formalisation of the HELICS criteria by the European CDC should allow standardised data collection throughout Europe, which will enable more consistent data collection and meaningful data comparison in the future. Our data add weight to the argument against routine oral chlorhexidine. The use of subglottic drainage endotracheal tubes in preventing ventilator-associated pneumonia is interesting and requires further investigation.

BackgroundManaging Emergencies in Paediatric Anaesthesia for Trainees (MEPAT) is an internationally recognised, peer reviewed and literature based simulation course which aims to give anaesthesia trainees the opportunity to develop skills in the management of paediatric anaesthetic emergencies.1 Anaesthetic training in the UK is competency based with a minimum of 60 individual assessments and 20 ‘Units of Training’ required to be signed off for completion of Intermediate training alone.2 Previous work has mapped the MEPAT course to the Royal College of Anaesthetists UK (RCoA) coded competencies to create a curriculum map.3 Following positive feedback from trainees using this curriculum map we had requests to embed Work Place Based Assessments into the MEPAT course – we piloted the use of standardised Case Based Discussion (CBD) templates.MethodologyWe reviewed learning objectives (LO’s) within the MEPAT scenarios alongside our local MEPAT database of ‘Take Home Messages’ (THM’s) – reported learning outcomes from course participants following each structured debrief. THM’s matched the LO’s set out for each scenario and were consistent across all courses. Following this analysis we felt confident that our MEPAT debriefs or ‘simulated case based discussions’ were standardised – allowing us to create a CBD Template for each scenario using the THM’s as core themes for discussion. The template could then be easily transferred to the RCoA electronic portfolio.ResultsFeedback from trainees and specialist paediatric anaesthetists has been extremely positive. It has allowed trainees to sign off several different competencies within one MEPAT scenario and has provided the assessor with a template to work from therefore minimising the substantial workload required to complete each CBD.Potential impactWe hope that our work in both curriculum mapping and CBD templates can be used by the RCoA as a model for embedding simulation into the anaesthetic training curriculum.References2010 Curriculum for a CCT in Anaesthetics, Edition 2 Version 1.6. A publication by the Royal College of Anaesthetists UK, August 2010, Annex CWinton P, Armstrong L. Mapping ‘MEPAT’ Paediatric Anaesthesia Simulation Course to the RCoA (UK) Curriculum. Poster Presentation – Association of Paediatric Anaesthetists of Great Britain and Ireland Annual Scientific Meeting, Aberdeen, May 2015