PP032 Topic: AS03–Disaster Medicine/Trauma, Triage and Transport/Mass Critical Care/Pandemics/Medicine in War Zones/Other: THE IMPLEMENTATION OF CONTINUOUS POSITIVE AIRWAY PRESSURE IN A HUMANITARIAN CONTEXT: THE EXPERIENCE OF MÉDECINS SANS FRONTIÈRES IN MOSUL, IRAQ
Bibliographic record
Abstract
Aims & Objectives: Continuous Positive Airway Pressure (CPAP) is recommended for neonates with respiratory distress. CPAP is widely used in high-income countries, but less so in low- and middle-income settings. We aimed to report our experience in a humanitarian setting. Methods: MSF implemented CPAP in a basic neonatal unit in Mosul following the request of the local team. Implementation of two bubble CPAP machines included initial training and refresher training one year later. Clinical data was recorded over 16 months (13 April 2021- 21 July 2022). Descriptive statistics were used to assess the feasibility and outcomes of using CPAP in this setting. Results: CPAP was well accepted by most healthcare workers and parents. 93 neonates were placed on CPAP. The main indications were respiratory distress syndrome, pneumonia, transient tachypnea, and meconium aspiration (46%, 22%, 16%, and 14% respectively). Average duration on CPAP was 53 hours. 63% of patients recovered, 8% were discharged against medical advice, 9% were referred, and 15% died. Among patients who died, 41% had a contraindication to CPAP, and the initiation of CPAP was delayed in 53% of patients. Complications included minor nasal lesions (17%), irritability (8%), and pneumothoraces (5%). Conclusions: Using CPAP in a humanitarian setting is feasible. Most patients improved and were discharged home. 5% of patients developed pneumothoraces, which is in keeping with other reports. Among patients who did not improve, a significant proportion had contraindications to CPAP initiation and/or were placed on CPAP in extremis, highlighting the importance of clear indication criteria and training. Keywords: CPAP, Humanitarian setting, Continuous Positive Airway Pressure, Paediatric Emergency & Critical Care
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".