Survey – Dolphin CPAP – LifeKit by MTTS

SURVEY – DOLPHIN CPAP

Dear Colleague, this is a short survey to assess your opinion about the use of the Dolphin CPAP in your neonatal intensive care unit (NICU). The participation in the survey takes about 10 minutes of your time.

Your opinion is very important for us.

A. GENERAL INFORMATION

1. Hospital Name *

2. How many years have you been working in NICU? *

3. How many patients per year (approximately) do you treat with CPAP at your NICU? *

4. How many years have you been using Dolphin CPAP at your unit? *

B. DEVICE PERFORMANCE

Rate your experience by selecting number of stars: (1 = strongly disagree; 5 = strongly agree).

5. Stability of FiO₂ during use *

6. Overall clinical performance as intended use *

C. USABILITY AND ALARMS

Rate your experience by choosing number of stars: (1 = strongly disagree; 5 = strongly agree).

7. Ease of setup and operation *

8. Clarity and usefulness of alarms *

9. Clarity of Instructions for Use (IFU) *

10. Ease cleaning and maintenance *

D. SAFETY

11. Have you observed any unexpected side effects during use? *YesNo

If Yes, please describe:

12. Have you encountered any device malfunctions? *YesNo

If Yes, please describe:

E. MISUSE / OFF-LABEL USE

13. Have you observed any misuse? *YesNo

If Yes, please describe:

14. Have you observed off-label use (e.g., infants >10 kg)? *YesNo

If Yes, please describe:

F. CLINICAL BENEFITS

NOTE: Following questions should base on your general clinical observations of therapy. Patient data or measured outcomes are not requested.

15. Do neonates typically show improved oxygenation (SpO₂ 89–96%) within the first 24 hours of Dolphin CPAP therapy? *Yes, consistentlyYes, sometimesRarelyNoNot sure

16. In your clinical observation, does the patient’s Respiratory Severity Score (RSS) generally improve within the first 24 hours of Dolphin CPAP therapy? *Yes, clear improvement (RSS improves noticeably)Yes, moderate improvementMinimal improvementNo improvementNot sure

G. If available, please record some representative cases below:

Patient 1

Baseline

Silverman

FiO₂

SpO₂

6 hours

Silverman

FiO₂

SpO₂

24 hours

Silverman

FiO₂

SpO₂

Patient 2

Baseline

Silverman

FiO₂

SpO₂

6 hours

Silverman

FiO₂

SpO₂

24 hours

Silverman

FiO₂

SpO₂

Patient 3

Baseline

Silverman

FiO₂

SpO₂

6 hours

Silverman

FiO₂

SpO₂

24 hours

Silverman

FiO₂

SpO₂

Have you experienced any issues with the device you’d like to share: