neoSim by Nicutools

SCORING The debrief now scores what the baby needed rather than what was attempted. An intervention that was indicated but not delivered counts against the score instead of being left out of it — previously, skipping something could score better than doing it imperfectly. Ventilation, chest compressions and adrenaline are treated as critical actions. Not delivering one when it was indicated caps the overall score, and the debrief states which action it was and the time it became indicated. Unnecessary adrenaline, compressions, UVC insertion, intubation and needle decompression are now grouped as safety events rather than sitting among the checklist items. Earlier scores are unchanged and remain in the training log. Sim of the Day percentiles are compared within a scoring version, so earlier scores are not ranked against the new ones. SELF-INFLATING BAG Sims can now be authored with a self-inflating bag in place of a T-piece resuscitator. Inflations are delivered by squeezing the bag; rate, depth and inspiratory time reflect the squeeze. The pressure-relief valve is set at 35 cmH₂O and can be held shut where higher pressures are required. The bag delivers no PEEP. An oxygen reservoir can be fitted and removed during the sim. Reservoir fill is integrated from delivered flow and modulates delivered FiO₂ below the source gas. Delivered FiO₂ from the bag is derived from published bench measurements in neonatal self-inflating bags (Sasi et al., J Paediatr Child Health 2013). On 100% source gas without a reservoir it is approximately 75% at 1 L/min and plateaus near 94%; the commonly taught 40% is reached only at about 0.2 L/min (which cannot be delivered on the installed flow meter) Fixed bug where the chest did not move during bag inflations. Delivered tidal volume, scoring and the infant's response were correct throughout — only the chest movement was missing, so effective ventilation could read as ineffective. OXYGEN CYLINDER SUPPLY Gas supply is authored independently of the device, so either a T-piece or a bag may run on blended gas or on a cylinder. Where a cylinder is used there is no blender and flow rate is the only oxygen control: contents deplete with use, delivered flow tapers below 20 bar, and a spent cylinder can be exchanged mid-sim. TRANSILLUMINATION The cold light glow is smaller, brighter and less red, so it reads against well-perfused skin rather than only against a cyanosed chest. Saturated red is now reserved for the affected hemithorax under tension pneumothorax, widening the contrast between sides. Fixed bug where transillumination wand disappeared behind the chest. OTHER CHANGES - Laryngeal mask (i-gel) insertion is animated through the full placement sequence. - Subcostal recession intensity scales with central respiratory effort, not chest wall movement alone. - Reduced chest excursion for normal spontaneous breathing. - Solo sims no longer end early while a pneumothorax is being assessed with the cold light. - Shared sim links can be set to last up to six months and have no limit on the number of plays. An expired link now names the sim and who sent it.

SELF-INFLATING BAG Sims can now be authored with a self-inflating bag in place of a T-piece resuscitator. Inflations are delivered by squeezing the bag; rate, depth and inspiratory time reflect the squeeze. The pressure-relief valve is set at 35 cmH₂O and can be held shut where higher pressures are required. The bag delivers no PEEP. An oxygen reservoir can be fitted and removed during the sim. Reservoir fill is integrated from delivered flow and modulates delivered FiO₂ below the source gas. Delivered FiO₂ from the bag is derived from published bench measurements in neonatal self-inflating bags (Sasi et al., J Paediatr Child Health 2013). On 100% source gas without a reservoir it is approximately 75% at 1 L/min and plateaus near 94%; the commonly taught 40% is reached only at about 0.2 L/min. OXYGEN CYLINDER SUPPLY Gas supply is authored independently of the device, so either a T-piece or a bag may run on blended gas or on a cylinder. Where a cylinder is used there is no blender and flow rate is the only oxygen control: contents deplete with use, delivered flow tapers below 20 bar, and a spent cylinder can be exchanged mid-sim. OTHER CHANGES - Laryngeal mask (i-gel) insertion is animated through the full placement sequence. - Subcostal recession intensity scales with central respiratory effort, not chest wall movement alone. - Reduced chest excursion for normal spontaneous breathing.

The 2.7 series brings neoSim's biggest visual upgrade yet, plus more realistic physiology. A new 3D chest • A true 3D torso replaces the flat manikin — lifelike chest rise, indrawing and colour change. • "Cold Light" transillumination now shines applied via a "wand" not your finger-tip for better visibility, with the affected side glowing red under a tension pneumothorax. Smarter thermoregulation • Plastic wrap now properly keeps preterm babies warm — and is offered for any baby under 1500 g. • Cold babies now show depressed breathing (apnoea when severe), reversing on rewarming. • Overheating now behaves realistically by gestation.

• Meet the new 3D newborn — a fully three-dimensional chest that rises, retracts and changes colour in real time, so every breath, compression and intervention feels true to life. • Cold Light transillumination now uses a handheld wand — your finger no longer blocks the glow when localising a pneumothorax, with cleaner, more realistic light. • Tension pneumothorax — the affected side now shows subtle chest movement and indrawing instead of sitting frozen, recovering as you decompress. • Refined scoring for chest-compression response. • Stability and polish.

Nasal CPAP: choose nasal CPAP for preterm RDS instead of mask PPV. Available for babies ≤32 weeks. LISA (Less Invasive Surfactant Administration): give surfactant via thin catheter without intubating. Tap Surfactant with no ETT in place to start LISA; with an ETT in, it gives the INSURE dose. Ability to bail out of LISA if infant unstable Failed intubation: pick a tube that's too large for the baby and you'll now see the attempt play through: blade in, tube enters, tube withdraws, advisory across the top. Code button: bell glyph plus a clearer red-to-green colour change when help has been called. Vagal HR drop while the laryngoscope blade is in the airway.