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1636 Premedication for Neonatal Intubation: Current Practice in the Tertiary Neonatal units in the United Kingdom
  1. Y Singh,
  2. M Lester,
  3. V Ng,
  4. L Miall
  1. Neonatal Medicine, The Leeds Teaching Hospitals NHS Trust, Leeds, UK

Abstract

Background Evidence clearly shows that awake intubation is associated with a significantly higher intracranial pressure, higher blood pressure, and more variable heart rate than premedicated intubation. The last national survey was over 10 years ago. Recently there has been promising research on use of Propofol during neonatal intubation which showed it to be more effective than the morphine, atropine and suxamethonium.

Aims To establish and up to date census on the current use of premedications to facilitate neonatal intubation in the UK tertiary neonatal units.

Design and methods Telephone survey included all the 44 tertiary neonatal units in the UK. Professionals were asked about their current practice in use of pre-medications during neonatal intubation.

Results 44 tertiary neonatal units were contacted and all units use pre-medications to facilitate intubations. 40 of the 44 units (91%) have written guideline or protocol. 6 premedication drugs are being used in 10 different combinations.

Combination of Fentanyl, Atropine and Suxamethonium is the most commonly used drug regimen used by 16 of 44 units (36%) while 2nd most popular regimen (used by 25%, 11 of 44 units) included combination of Morphine, Atropine and Suxamethonium. Propofol is being used in only one unit.

Conclusion Use of premedications to facilitate intubation has become standard practice across the tertiary neonatal units in the UK. However practice varies in terms of choice, number and doses of premedication drugs. Six premedication drugs are being used in 10 different combinations/regimens which vary from 1–3 drugs.

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