Do you medicate for intubation?

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Specializes in NICU.

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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Specializes in NICU.

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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Specializes in NICU, PICU, educator.

oops double post

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Specializes in NICU, PICU, educator.

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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Specializes in NICU/Neonatal transport.

Non-emergent tubes get meds...sux, fent, atropine.

Emergent tubes, we just pray they get in there (sometimes *L*)

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Specializes in NICU.

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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Specializes in NICU/Neonatal transport.

I think we use sux because it wears off faster than the vec.

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Specializes in NICU.

Thanks, Lilpeanut. The one from the article is a new-ish one. Started with an M...

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Specializes in NICU.

We also have sux available for the bigger kids - although I can't remember ever using it...

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Specializes in NICU- now learning OR!.

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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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?

We try to for all intubations in the unit...Fent. or Versed.

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