Does your unit routinely provide pain or sedative drugs to intubated patients?

Specialties NICU

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Specializes in NICU.

My 58 bed unit has no policy for pain/sedation for intubated patients, despite the fact that this is common practice in Ped and Adult units in our hospital. I know that other NICU's provide this in the form of drips or prn's. Our docs feel drugs will keep babies on the vent longer and prolong the time to extubation. As you know, there is a big push to early extubation. We see frequent bradys and desats in our intubated patients and I worry about the affect on brain development in the ELBW and VLBW populations. If your unit has a policy for this, could you provide the EBP on which you base your decision?

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Specializes in L/D 4 yrs & Level 3 NICU 22 yrs.

We don't have a policy per se, but all intubated babies have PRN fentanyl/versed and many have fent drips. One would hope that the only EBP you would need is that neonates feel pain and being intubated is certainly an uncomfortable situation at best! Perhaps there is research out there that states "pain medication does not increase length of time on a ventilator" or something like that. Have you done a lit search yet? Start there and good luck with this endeavor. The babies will thank you.

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No policy and it makes me mad! I am a new grad so not very experienced in this area but I have seen numerous vented babies without drips and only PRN's if that, we also commonly have oscillating babies w/o drips or PRN's. You have to really advocate and work with the docs to get anything. One kiddo I had we didnt get any drips/prns until the kid bronchospasamed twice requiring chest compressions. Then we got morphine/versed. It bugs me too because then the docs wonder why kids keep extubating themselves, well duh, their not, stupid, they don't want the tubes down their throats! Intubate me and you better give me something good if you want that tube to stay put! :uhoh3:

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Specializes in NICU Level III.

None. I've seen ONCE a baby get an IVP of versed prior to intubation.

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None. I've seen ONCE a baby get an IVP of versed prior to intubation.

I'm pretty sure we at least get versed always before intubation

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Specializes in NICU Level III.
I'm pretty sure we at least get versed always before intubation

Are you at my facility and saying we do?? I've been present for quite a few and I only remember the most recent one getting the versed.

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Are you at my facility and saying we do?? I've been present for quite a few and I only remember the most recent one getting the versed.

oh no! I don't think so haha, I was just replying kind of shocked and saying that at least where I am most of the kids get something to knock them out while the tube gets shoved down their throats. Misunderstanding! lol

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Specializes in NICU.

i'm at a nationally ranked level 3c nicu...we give versed and/or fentanyl for non-emergent intubations...we try to give it always if possible...but then sometimes you have those situations that arise when it'sjust not possible to do it in time...for those of you who are mad that your institutions dont, i'd suggest to them to imagine how they'd feel if their baby was being intubated without pain meds...or if it was themselves being intubated without pain/sedation...ouch...no thanks...i'm doing my masters and would always be in favor of at least some versed...

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