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ObjectivesRespiratory distress is the commonest cause of term admission to Neonatal Unit. However, two-thirds were only admitted for less than 48 hours.1 The audit as outlined in the ATTAIN SOP: Avoiding Term Admissions in Neonatal Units – Respiratory Management of Term infant in the First Hour Following Birth and analyse the outcome for babies in whom ‘Trial of PEEP’ is attempted. In this audit trial of PEEP was performed in new-borns > 37 weeks’ gestation who requiring respiratory support immediately after birth. PEEP was given at 6cm H2O for 30 minutes. [figure 1] The outcomes were then analysed to identify potential avoidance of term admission and rooms for improvement in practice.Abstract 6048 Figure 1MethodsPatient samples were collected between March and June 2023. Initial collection in March to May was not effectively collected with missing information, prompting a creation of specialized form and allocation to colleagues in May to June. Additional data on babies undergoing ‘trial of PEEP’ was identified. Excel was used for analysis, focusing on descriptive analysis.ResultsIn this study, a total of 19 patients were included, but 4 of them were excluded because positive end-expiratory pressure (PEEP) was applied more than 1 hour after birth. Among the new-borns who received a PEEP trial at birth, 40% successfully avoided admission to the Neonatal Unit (NNU). [figure 2] Impressively, 83% of these new-borns did not require septic screens or antibiotics, underscoring the effectiveness of PEEP. Additionally, 66% of the babies admitted to NNU only needed high-flow oxygen support for less than 8 hours. Notably, three infants received PEEP for less than 30 minutes and were immediately admitted to the NNU due to ongoing respiratory distress, while three others with similar PEEP durations were observed in the postnatal ward after their respiratory effort normalized. Prolonged rupture of membrane (PROM) was identified in three patients who developed respiratory distress at 5 hours, 6 hours and 1 hour with significant meconium and failed the ‘Trial of PEEP’.Abstract 6048 Figure 2ConclusionThe initial findings suggest that employing the ‘Trail of PEEP’ during delivery benefits term and late-preterm infants experiencing respiratory distress at birth. This approach appears to lower admissions to the Neonatal Nursing Unit (NNU), promoting maternal-infant bonding, reducing antibiotic usage, and potentially saving costs by averting NNU admissions. However, it’s important to note that patients with Premature Rupture of Membranes (PROM) may have a distinct respiratory distress mechanism and may not respond as effectively to PEEP.ReferenceReducing harm leading to avoidable admission of full-term babies into neonatal units, NHS Improvement, February 2017.

ObjectivesThe attrition rate during the early years of paediatric training in the UK remains a significant concern. Thus, it is important to ensure ST1 doctors are sufficiently supported from the outset of their training. The West Midlands Paediatric Trainees’ Committee have developed a ‘Welcome to Paediatrics’ day for new paediatric ST1 doctors, one day before their official start of training. The ‘Welcome to Paediatrics’ day aims to improve the confidence of ST1 doctors before commencing their first paediatric training post and to cultivate a sense of wellbeing.MethodsNewly recruited ST1 doctors in the region were invited to attend a ‘Welcome to Paediatrics’ face-to-face induction event. The training day consisted of a series of talks and workshops with topics such as portfolio, examinations and an open faculty-led conversation about challenges in paediatrics. Pre and post-event surveys were conducted before and after the event to evaluate the main concerns and to assess the impact of the event. The surveys consisted of open-ended questions with a Likert scale assessing confidence.ResultsThere were 28 and 17 responses for the pre and post-event survey respectively; all responses were anonymous. Braun’s framework was used to conduct a thematic analysis of the responses. The primary concerns of new ST1 doctors identified in the pre-session survey were broadly divided into six categories: portfolio, knowledge and skills expected, neonates, work-life balance, work environment and exams. In the post-event survey attendees focussed on the positive environment in which the event was conducted, with a particular focus on the benefit of honest reflections and discussions centered around wellbeing. The themes that attendees found most useful in the post-event survey included: wellbeing, portfolio, less than full time working and peer networking. Following the event there was a marked increase in confidence with 94% of attendees feeling ‘confident’ or ‘very confident’ after the event, compared to only 44% before the event.ConclusionsThe ‘Welcome to Paediatrics’ day increased the confidence of ST1 doctors starting paediatric training in the West Midlands. ST1 doctors appreciated the two-pronged approach, which provided both practical information as well as an emphasis on wellbeing. A similar day could be arranged in different deaneries and for different specialties.