Laryngeal intubations?

Specialties NICU

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Our unit is going to start doing this and it sounds scary! Anyone else do this?

Specializes in Level II & III NICU, Mother-Baby Unit.
It is my understanding that this is not intended to replace standard intubations in neonatal resuscitation, just to provide a temporary alternative in cases where intubation is especially difficult, like a child with anatomical abnormalities. If such a child required resuscitation in the DR, this technique could be used to temporarily secure an airway. Code drugs would have to be given by other means such as a UVC or PIV. Tracheal suctioning could be accomplished by temporarily removing the mask, visualizing the cords, suctioning directly, then replacing the mask if ventilation is needed.

Once the baby is stabilized in the DR, and transferred to the NICU, other airway options would be considered.

I think this could also be useful in situations where there is no one skilled in neonatal intubations present at a delivery, such as out of hospital births, deliveries in the ER, and small, rural hospitals with limited specialized staff.

Jolie, your post sounds like you attended the same nursing conference and listened to Dr. Goldsmith's speech. You very nicely hit the nail on the head for me... I can get too wordy... you put it nicely in a nut shell. Dr. Goldsmith said that it could be used even in a delivery in a regular hospital that delivers babies all the time too in the cases where the intubating personnel are unsuccessful (so we should have them on our code carts). He also made us aware that NRP is not only taught to us in the developed countries but all around the world where laryngeal mask airways could come in very handy...

:w00t: :thankya:

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Specializes in Maternal - Child Health.
Jolie, your post sounds like you attended the same nursing conference and listened to Dr. Goldsmith's speech. You very nicely hit the nail on the head for me... I can get too wordy... you put it nicely in a nut shell. Dr. Goldsmith said that it could be used even in a delivery in a regular hospital that delivers babies all the time too in the cases where the intubating personnel are unsuccessful (so we should have them on our code carts). He also made us aware that NRP is not only taught to us in the developed countries but all around the world where laryngeal mask airways could come in very handy...

:w00t: :thankya:

Thanks for your comment. You made my day:) I have not attended any conferences lately; I'm just drawing on past experience when we "improvised" airways for babies who needed, but couldn't be intubated in the delivery room, for a variety of reasons. I started neonatal nursing 20 years ago, before NICU and L&D RNs had NRP training, and before there was any standard of having delivery room personnel skilled in intubation. We've come full circle. Funny how that happens!

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I can't imagine what our director is thinking of . Like I said, I am scared!!! Lord, help us!

Renewing my NRP next month.Thought I'd be in and out of there, but with these changes.......Anyone want to by an old NRP book? ;)

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Specializes in Level II & III NICU, Mother-Baby Unit.

Don't freak yet DawnGloves because I am pretty sure that the NRP instructors are supposed to continue teaching NRP as they have for the past few years until the new books come out in May. I think that they are just supposed to pass on the information that is coming so we can all be a little prepared, but for now our NRP guidelines have not changed... at least for another month or two. I'm going to be renewing mine at the end of this month too! I'm just curious if we will have to renew it again when the new guidelines come out...

:lol2:

Jolie, you have great instincts! It really is amazing how nearly everything in life comes full circle.... including things like fashion and even growing older... I'm watchng my mom get older and it's difficult to see; especially knowing that it will be my turn within the next 30 years or so. I guess that's why we call it "the circle of life". As you said, even baby resuscitation seems to have it's own circle of life!

:lol2:

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Specializes in NICU, Infection Control.

https://allnurses.com/forums/f16/laryngeal-mask-neonates-169006.html#post1744219

I'm just cross-referencing these 2 threads. I'm not sure how I can merge them--I put this one in CRNA so they could answer our questions.

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