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Jan 09, 2008, 01:03 AM
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ECMO junkie
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Do you medicate for intubation?
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Hey y'all. We're finally getting moving on this pain-management stuff over here (thanks to the illustrious Steve), and as the self-appointed research nerd, I've found a really interesting article on premedication for non-emergent intubation. The article focuses on medication with atropine, fentanyl, and with/without a muscle relaxant. This got me thinking. We (surprise!) don't medicate for intubations at ALL. Like, not ever. Do you? What do you use? What have you noticed?
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Jan 09, 2008, 08:03 AM
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Senior Member
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Re: Do you medicate for intubation?
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Every once and a while we do. I've seen it done more on the big chronics who self-extubated (again...) and are just to big and strong for any type of successful intubation with out being at least a little sedated. However - the one's I've had already had IVs... so administering some Fentanyl wasn't that big of a deal. I'm not sure what we would do w/o IV access... not going to spend time starting an IV just for that.
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Jan 10, 2008, 06:32 AM
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Senior Member
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Re: Do you medicate for intubation?
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oops double post
Last edited by BittyBabyGrower : Jan 10, 2008 at 06:34 AM.
Reason: double pst
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Jan 10, 2008, 06:33 AM
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Senior Member
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Re: Do you medicate for intubation?
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Depends on the kid...if he has a line and is fighting terribly then yes we sedate...if it is a total emergency, he just gets tubed and medicated after. If it is a bigger kid going for a procedure then we do sedate then intubate. We don't rapid sequence anyone in our unit. We have dripped versed up their noses if no access is available.
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Jan 11, 2008, 01:58 AM
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Re: Do you medicate for intubation?
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Non-emergent tubes get meds...sux, fent, atropine.
Emergent tubes, we just pray they get in there (sometimes *L*)
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Jan 11, 2008, 02:12 AM
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ECMO junkie
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Re: Do you medicate for intubation?
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Not that I'm in any position to be talking about evidence-based practice as it comes to this stuff (lol), but I though sux wasn't used much in the neonatal population anymore? We only use vec on our unit, although in the OR sometimes they use rocuronium for the belly kids.
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Jan 11, 2008, 02:36 AM
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Re: Do you medicate for intubation?
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I think we use sux because it wears off faster than the vec.
The following member says Thank You:
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Jan 11, 2008, 02:57 AM
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ECMO junkie
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Re: Do you medicate for intubation?
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Thanks, Lilpeanut. The one from the article is a new-ish one. Started with an M...
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Jan 11, 2008, 04:06 AM
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Senior Member
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Re: Do you medicate for intubation?
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We also have sux available for the bigger kids - although I can't remember ever using it...
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Jan 12, 2008, 12:00 PM
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Re: Do you medicate for intubation?
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Hi,
We use Atropine and 2 mcg of Fentanyl on non-emergent intubations (it is now standard policy) but to be honest, I still have to fight with the Neos to get them to agree to order it. Sometimes, they flat out refuse and other times there has not been IV access.
Jenny
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