To demonstrate methods and landmarks for mediastinum ultrasound as part of ultrasound
examination of the lung for nurses. This will be the first step in their education
to detect finally the tubes and lines malpositioning in order to distinguish emergency
conditions of the lungs in neonates hospitalized in neonatal intensive care units.
Design and methods
Theoretical and practical interventions were developed to create a 3-month training
program based on similar medical courses. The study was approved by the hospital's
ethics committee.The program was performed in the neonatal intensive care unit of
a single academic institution. Participating nurse was supervised by a paediatric
surgeon and trained in lung ultrasound (a safe method without radiation) by a paediatric
During the practical period (2 months), the neonatal intensive care unit nurse examined
50 neonates (25 + 6–40 + 4 weeks gestational age; 21 males) separated into two subgroups
of 25 neonates each for each training month. In the first month under supervision,
the nurse was trained to recognise the aortic arch, the right pulmonary artery, the
esophagus, the tracheal air, and the ‘sliding lung sign’ in the anterior, lateral,
and posterolateral aspects of the thoracic cage. In the second month, the nurse recorded
the ultrasound examinations. The identified structures were then assessed and graded
by the supervising radiologist. The overall estimated success rate (5 landmarks ×
25 neonates = 125) was 90.4%.
Although this is the first report of the design of a ‘hands-on’, lung ultrasound training
program for neonatal intensive care unit nurses, our findings demonstrate that it
is a safe and useful program for all neonatal intensive care unit nurses because theoverall
success rate of the 3-month program was determined by accurate identification of basic
anatomical structures (90,4%) by the nurse.
This study describes the first educational training program for NICU nurses designed
to recognise basic structures in the neonatal mediastinum. If the program is effective,
NICU nurses will be able to identify respiratory emergencies. NICU nurses can inform
doctors about emergencies according to tubes and lines malpositioning in a timely
manner to avoid negative consequences.