A CHECK-LIST of items to consider when you're having a TOUGH time with a baby's intubation! How is the ETT inserted? How do you position yourself for an intubation? And the baby? What if the cords are super anterior? Do you always suction? Use a stylet? How can pre-medication and HFNC help? What if the cords are closed? Is your equipment functioning? Learn our recommendations here!
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
NRP textbook 8th edition
Hodgson KA, Owen LS, Kamlin COF, Roberts CT, Newman SE, Francis KL, Donath SM, Davis PG, Manley BJ. Nasal High-Flow Therapy during Neonatal Endotracheal Intubation. N Engl J Med. 2022 Apr 28;386(17):1627-1637. doi: 10.1056/NEJMoa2116735. PMID: 35476651.
Kumar P, Denson SE, Mancuso TJ; Committee on Fetus and Newborn, Section on Anesthesiology and Pain Medicine. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010 Mar;125(3):608-15. doi: 10.1542/peds.2009-2863. Epub 2010 Feb 22. PMID: 20176672.
Steinhorn, R, De Ungria, M, Glob. libr. women's med.,(ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10203
Hatch LD, Grubb PH, Lea AS, Walsh WF, Markham MH, Maynord PO, Whitney GM, Stark AR, Ely EW. Interventions to Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics. 2016 Oct;138(4):e20160069. doi: 10.1542/peds.2016-0069. Epub 2016 Sep 21. PMID: 27694281; PMCID: PMC5051203.
Bensouda B, Mandel R, Mejri A, Lachapelle J, St-Hilaire M, Ali N. Effect of an audience on trainee stress and performance during simulated neonatal intubation: a randomized crossover trial. BMC Med Educ. 2018 Oct 3;18(1):230. doi: 10.1186/s12909-018-1338-4. PMID: 30285715; PMCID: PMC6171149.
O'Connell J, Weiner G Intubating extremely premature newborns: a randomised crossover simulation study BMJ Paediatrics Open 2017;1:e000157. doi: 10.1136/bmjpo-2017-000157
Kumar P, Denson SE, Mancuso TJ; Committee on Fetus and Newborn, Section on Anesthesiology and Pain Medicine. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010 Mar;125(3):608-15. doi: 10.1542/peds.2009-2863. Epub 2010 Feb 22. PMID: 20176672.
https://www.mayoclinic.org/diseases-c...
https://www.childrens.health.qld.gov....
https://www.clinicalguidelines.scot.n...
https://www.medline.com/media/mkt/pdf...
https://ars.els-cdn.com/content/image...


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**TIMESTAMPS**
00:08 Attempt often
00:59 Find perfect view
01:57 Baby's level is ideal
02:39 Use curve of ETT
03:15 Use correct size blade
04:07 Intubate in 30 seconds
04:44 Baby is stable during attempt
05:18 Premeditate
05:48 Use readers
06:36 Try learning without a stylet
07:59 Be prepared for closed vocal cords
08:32 Be prepared for difficult intubations
09:37 Set up perfect environment
10:14 Avoid suction unless necessary
11:08 Make sure bulb is working
12:00 Do not trust pedicab blindly
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.