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Respiratory Software
Neonatal Self-Evaluation Clinical Simulations

Each Neonatal Self-Evaluation Clinical Simulation features the following:
  • Format closely follows the computerized credentialing clinical simulations.  For teaching purposes, the neonatal clinical simulations may contain more sections than the actual credentialing clinical simulations (each neonatal clinical simulation contains a minimum of 15 sections on the optimal path).
  • A detailed score report that includes the IG score, DM score, total score, proficiency score, efficiency score, errors of omission score, errors of commission score, and overall competence score.
  • After the user has seen his/her score report, he/she will have the opportunity to print the score report and (if you have set the program to teach mode) to review each section of the simulation to view the correct responses and compare them to his/her responses.
  • While viewing responses, the user is provided an explanation that identifies the rationale behind the correct response(s).
  • Use the Respiratory Administrator to set teach / test mode, passwords, and view users and scores.

Note: these programs are for institution purchase only.

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NCS-01: Apnea of Prematurity - This clinical simulation evolves around the management of a neonate, born at 30 weeks' gestation, who develops periodic episodes of apnea and then sustained apnea. Decisions relative to clinical and laboratory assessment, pathophysiology, performing a polysomnography study and interpreting the results, implementing neonatal care procedures to lessen the apneic episodes, administering caffeine to control the apneic episodes, initiating bag and mask ventilation for sustained apnea, selecting an appropriately sized endotracheal tube, initiating mechanical ventilation and setting initial ventilator parameters, selecting an appropriately sized suction catheter and performing endotracheal suctioning, and adjusting ventilator parameters are required.

NCS-02: Aspiration Pneumonitis - This clinical simulation evolves around the management of a 2-day-old female infant who presents with cyanosis after vomiting her feeding. Decisions relative to clinical and laboratory assessment, oxygen administration, bronchial hygiene, pharmacology, NCPAP therapy, initiation of bag and mask ventilation for respiratory distress, selecting supplies and equipment required for endotracheal intubation, selecting an appropriately sized endotracheal tube, determining appropriate intervention for a failed intubation attempt, initiation of mechanical ventilation and setting initial ventilator parameters, calculating the delivered I:E ratio, assessing the patient/ventilator system, recommending sedation and paralysis for a hyperactive infant, and pathophysiology are required.

NCS-03: Bronchopulmonary Dysplasia - This clinical simulation evolves around the management of a 26 weeks' gestation male neonate who requires increasing ventilatory support with HFOV and subsequently develops bronchopulmonary dysplasia. Decisions relative to clinical and laboratory assessment, endotracheal suctioning, following appropriate suctioning technique, initiating manual ventilation for respiratory distress, assessing the patient/ventilator system, repositioning a malpositioned endotracheal tube, adjusting HFOV settings, weaning from HFOV, instituting APRV and adjusting APRV settings, and extubating to NCPAP with subsequent assessment are required.

NCS-04: Cardiopulmonary Resuscitation - This clinical simulation evolves around the management of a 12-hour-old neonate who becomes lethargic and unresponsive. Decisions relative to clinical and laboratory assessment, initiating bag and mask ventilation via flow-inflating bag, determining appropriate ventilatory rate and inspiratory pressure during manual ventilation, troubleshooting the flow-inflating bag, adjusting the inspiratory pressure delivered from the flow-inflating bag, initiating chest compressions, determining the chest compressions to positive pressure ventilation ratio and coordinating manual breaths with chest compressions, performing endotracheal intubation and administering epinephrine through the endotracheal tube, assessment following epinephrine administration, discontinuing chest compressions and initiating mechanical ventilation, setting initial ventilatory support parameters, assessment following the initiation of mechanical ventilation, and adjusting ventilator parameters are required.

NCS-05: Congenital Diaphragmatic Hernia - This clinical simulation evolves around the management of a 5-hour-old female neonate who develops poor chest excursions with respiratory distress. Decisions relative to clinical and laboratory assessment, pathophysiology, intubation and manual ventilation, post-operative assessment, insertion of a right-sided chest tube, initiation of mechanical ventilation, determining the inspiratory time and flow rate required to obtain volume-targeted ventilation with a pressure-controlled ventilator, ventilator waveform interpretation, adjusting ventilatory support parameters, weaning from mechanical ventilation, and extubation to NCPAP are required.

NCS-06: Congenital Lobar Emphysema - This clinical simulation evolves around the management of a two-week old infant presenting with respiratory distress. Decisions relative to clinical and laboratory assessment, oxygen therapy, pathophysiology, NCPAP therapy, initiation of mechanical ventilation and setting initial ventilator parameters, adjustment of ventilator parameters, ventilator waveform interpretation, corrective action for waveform abnormality, assessment for post-operative infection, and appropriate therapeutic intervention are required.

NCS-07: Delivery Room Management - This clinical simulation evolves around the management of a 24 weeks' gestation neonate who presents limp and cyanotic with minimal respiratory effort at birth. Decisions relative to preparing resuscitation equipment, ensuring that the delivery room is adequately stocked with various neonatal resuscitation supplies and equipment, ensuring that the appropriate medications and resuscitative fluids are readily available, administering supplemental oxygen to the mother due to the onset of fetal late decelerations, providing free-flow oxygen to the neonate immediately after birth, assessing the neonate to determine if resuscitative actions are indicated, initiating positive pressure ventilation via bag and mask, determining the cause for the chest not rising during manual ventilation, recommending endotracheal intubation, assessing the neonate following intubation, initiating chest compressions, assessing the neonate following the initiation of chest compressions, administering epinephrine through the endotracheal tube, assessing the infant following the administration of epinephrine, and considering terminating resuscitative efforts for lack of a heart rate are required.

NCS-08: Extreme Prematurity - This clinical simulation evolves around the management of a 25 weeks' gestation neonate who is depressed and apneic at birth. Decisions relative to clinical and laboratory assessment, patient/ventilator assessment, interpreting the ventilator waveform and taking corrective action for the abnormality, adjusting ventilatory support parameters, manually ventilating and performing transillumination of the chest for a suspected pneumothorax, performing needle thoracentesis with subsequent insertion of a chest tube, obtaining a follow-up chest x-ray with interpretation of the results, pathophysiology, instituting high frequency oscillatory ventilation (HFOV), adjusting HFOV settings, and determining the initial goals for weaning from HFOV are required.

NCS-09: Meconium Aspiration Syndrome - This clinical simulation evolves around the management of a 42 weeks' gestation neonate who presents meconium-stained at birth. Decisions relative to maternal and fetal assessment, pathophysiology, performing preventative meconium aspiration measures, assessing the neonate post-delivery, determining the Apgar score, administering free-flow oxygen, transferring to the NICU and initiating supplemental oxygen via oxygen hood, troubleshooting the oxygen hood system, adjusting the delivered oxygen concentration, initiating nasal CPAP and setting initial CPAP pressure, adjusting the CPAP level, performing clinical and laboratory assessment relative to a distressed neonate, manually ventilating and performing endotracheal intubation, extubating and re-intubating with a larger-sized endotracheal tube when faced with significant leaks in the infant/ventilator system, performing endotracheal suctioning, and recommending switching to high-frequency oscillatory ventilation are required.

NCS-10: Neonatal Transport - This clinical simulation evolves around the management of a neonate who requires transport to a tertiary care center. Decisions relative to selecting equipment and supplies necessary for the transport, performing clinical and laboratory assessment, performing endotracheal intubation and initiating mechanical ventilation, selecting initial ventilatory parameters, determining the ventilatory I:E ratio, adjusting ventilatory parameters, monitoring the neonate while in transport, extubating and re-intubating, and performing a post-intubation assessment are required.

NCS-11: Patent Ductus Arteriosus - This clinical simulation evolves around the management of an intubated and mechanically ventilated neonate. Decisions relative to clinical and laboratory assessment, repositioning the endotracheal tube, inserting a left-sided chest tube for a left-sided pneumothorax, initiation of manual ventilation with troubleshooting of the patient/ventilator system, troubleshooting the transcutaneous PO2 electrode, performing endotracheal suctioning, interpreting clinical findings of a patent ductus arteriosus (PDA), recommending diagnostic studies that would confirm the clinical findings, and extubating to NCPAP are required.

NCS-12: Persistent Pulmonary Hypertension - This clinical simulation evolves around the management of a neonate who presents depressed and limp at delivery. Decisions relative to clinical and laboratory assessment, delivery room resuscitation, oxygen therapy, NCPAP therapy, intubation with selection of an appropriately sized endotracheal tube, initiation of conventional mechanical ventilation and setting initial ventilator parameters, calculation of the oxygenation index (OI), initiation of HFOV and setting initial parameters, nitric oxide administration, and pharmacological interventions are required.

NCS-13: Pulmonary Interstitial Emphysema - This clinical simulation evolves around the management of a premature neonate who requires transport to a Level III NICU. Decisions relative to clinical and laboratory assessment, adjustment of oxygen therapy, initiation of NCPAP therapy, intubation and initiation of mechanical ventilation, adjustment of ventilator parameters, ventilator waveform interpretation, assessing the patient/ventilator system, endotracheal tube positioning, initiation of HFJV, adjustment of HFJV parameters, and servo pressure troubleshooting are required.

NCS-14: Respiratory Distress Syndrome - This clinical simulation evolves around the management of a preterm neonate who develops respiratory distress syndrome and subsequently requires increasing ventilatory support. Decisions relative to clinical and laboratory assessment, initiating mechanical ventilation and setting initial parameters, determining the optimal pressure support setting, interpreting the flow waveform and taking corrective action, repositioning a malpositioned endotracheal tube, pathophysiology, titrating the FIO2 to maintain adequate oxygen saturations, performing endotracheal suctioning, switching to HFOV and setting initial parameters, switching to HFJV when no improvement is noted with HFOV, adjusting HFJV parameters, and interpreting servo pressure changes are required.

NCS-15: Transient Tachypnea of the Newborn - This clinical simulation evolves around the management of a neonate delivered via emergency cesarean section who subsequently develops respiratory distress. Decisions relative to clinical and laboratory assessment, delivery room assessment and management, Apgar scoring, oxygen therapy, pathophysiology, initiation of NCPAP therapy, adjustment of NCPAP parameters, pharmacology, and discharge planning are required.

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