Assessment of intubation procedures at reference pediatric and neonatal intensive care units

Abstract

There was no established routine for intubation procedures in the units studied, and the use of muscle relaxants was not usual. The absence of adequate muscle relaxation is associated with more intubation attempts, difficulties and hypoxemia during the intubation procedure.

Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns

“…Consistent evidence has shown that conscious awake intubations cause adverse physiological responses and are painful 1 2 3 4. The short-term benefits of premedication for non-urgent intubation include more stable vital signs and faster intubations with fewer attempts, even with less experienced intubators 5 6 7 8 9 10 11 12 13.…”

“…Based on evidence, our clinical experience and availability of medications, we recently reviewed our premedication for non-urgent intubation guidelines to include atropine and fentanyl for all non-urgent endotracheal intubations 1 2 3 4 5 6 7 8 9 10 11 12 21 22 23 24. Succinylcholine is mandatory for infants 34 weeks or greater and at the physician’s discretion for those less than 34 weeks, mostly due to concerns with airway maintenance in smaller paralysed infants.…”