oral vs. nasal intubation

[preemieRNkate]

Just wondering what practice your unit uses for intubation, oral vs. nasal. We intubate our babies orally (unless of course there is some sort of anatomical defect that does not allow this). There is one hospital that we send babies out to for PDA ligations that always sends back the babies nasally intubated.

[skysurfer]

Septum breakdown is a huge issue with these kids who are vents for months and months.

There is a breakdown of a whole lot of other things, too, if a baby is intubated for months and months.......

We usually intubate our infants via nasal airway, simply because it´s

tolerated better by the infants and the fixation is more easy and

accurate. The infant is still able to train his/her suck-swallow rhythm

and can be calmed with a pacifier if necessary. We also administer glucose for painrelief that way.

However, in cases where a nasal intubation is not possible, we use the

neobar ETT holder for securing the tube. In all other (nasal) cases, we

have our very own technique of securing the tube. I would say it´s

"bomb-proof" and i have pictures that show how we secure our tubes.http://www.intensivmedicus.de/downloads/Tubusfixation.pdf

It is a safe way to intubate, if you´re trained. I´ve been told by a physician that comes from england, that there is a historical reason that in europe we prefer to intubate nasally (only small children) whereas in the english speaking countries they prefer to intubate orally. It is not a common practice for "youngsters"(young physicians) to intubate here in europe. It is only done by experienced residents. In the US,however, it is often performed by RT´s, Nurses or young physicians which are less trained, he said......

For all those who are interested in this, i have an english version also, which i could mail to you privately...

cheers Norbert aka Skysurfer

[LilPeanut, MSN, RN, NP]

Hmm. I'm not seeing what's all that different about the way we tape our oral tubes vs. your nasal tubes. And the differences that exist, why they couldn't be also used with oral intubation.

We've never had a major tissue breakdown with oral intubations that I know of, can you share your experiences?

[dawngloves, BSN, RN]

Hmm. I'm not seeing what's all that different about the way we tape our oral tubes vs. your nasal tubes. And the differences that exist, why they couldn't be also used with oral intubation.

We've never had a major tissue breakdown with oral intubations that I know of, can you share your experiences?

How about the palate?