nasal intubation

[Preemienurse23]

Do any of your units nasally intubate?

[Sweeper933]

I've seen it done only once on our unit. It was done for one of our chronics who had a really long course and just needed to be intubated for surgery. He had lots of oral aversion issues and would gag on everything. I'm sure there were more reasons for the nasal intubation - I just don't know them since I never took care of him!

[PageRespiratory!]

I've had many Pt's nasally intubated. The vast majority have been adults, a few kids with dental injuries. Never had a newborn however.

[NotReady4PrimeTime, RN]

I work in a PICU that also cares for a significant number of neonates post cardiac surgery. It's our standard of care in this facility to nasally intubate virtually all our patients (never mind that the VAP bundle strongly recommends oral intubation). The very rare patient will have an oral tube. We have a high incidence of sinusitis as a result.

[SteveNNP, MSN, NP]

The vast majority of our intubated kids are done so nasally. It is an antiquated, problem-ridden practice that is only done because our self-proclaimed pumonary doc refuses to change. As a result, we have a 20 min taping setup, horrible nasal erosion, and nare dilation. We also have a lot of intubations taking WAAAY too long.

Avoid it at all costs.

[Preemienurse23]

We had a baby with the Roban sequance that when extubated, he didnt want to breath. The Neo wanted to nasally intubate because he was going to be a hard intubation. The RT's fought it tooth and nail, just becuase of the problems that SteveRN21 listed. So instead he did noninvasive ventilation. Basically 2 long prongs inserted through the nose (duh!) and ended in the pharynax to provide CPAP. It was horrible. Very unstable, stressful, my kid had very little rest/sleep. We had to replace and retatpe his prongs 3-4 times in my 12 hr shift. I finally got the neo to put him on a HFNC at 6L and the change in my kid was huge. He calmed down and slept almost the last 4 hrs.

And I thought that nasal CPAP was bad with our prongs!!!!

[dawngloves, BSN, RN]

I only see it with the older chronics that go out for hernia repair or g tubes and they come back like that. We only keep them that way until they get all the happy gas out of their system and then we extubate.

[UTVOL3]

Never!

[danissa, LPN, LVN]

Me Neither, in all these years...............

[Preemienurse23]

I have only seen one pt nasally intubated, and it was an adult who had an unstable jaw fracture. After she had that repaired they orally intubated her.

[RN4Little1s]

We get some nasally intubated from other hospitals, but we really ever do it. I did have a Pierre Robin kid the other day nasally intubated.

[hikernurse]

I've never seen it. All of ours are orally intubated and that's bad enough for them. I can't imagine how awful being nasally intubated would feel.