1093 Attitude of foundation trainees towards Neonatal Medicine – a cross-sectional survey for quality improvement

Abstract

performed by a paediatric cardiologist and anaesthetist respectively. Evaluation of outcomes for patients who had received an echocardiogram prior to surgery vs those who hadn't, could then be performed according to severity of defects. Evaluation of sensitivity and specificity of various preoperative assessments was also performed to guide future echocardiogram requesting. Results Across the 5-year period 532 procedures were performed on 457 patients. 214 preoperative echocardiograms were completed, and 40 postoperative, in total 111 were found to be abnormal, and subsequently classified as -4 severe, 8 moderate and 99 mild (Summarised in table 1). Perioperatively the group who received echocardiography had 4 intraoperative cardiac arrests and 14 received intraoperative inotropes, compared to the 203 patients who did not receive echocardiography where 0 had cardiac arrests and 3 received intraoperative inotropes. A Fisher exact test analysis demonstrated a strong association between echo-defined severe CHD and instability under GA.The assessment criteria for whether or not echocardiography is required prior to surgery were defined as: antenatal scan (A), medical conditions (M), surgical conditions (S) and clinical and radiological signs (C). Using the AMSC criteria combined there was a 100% sensitivity for finding moderate or severe CHD on echo and a 95% sensitivity for predicting instability under general anaesthesia.