What drugs are given before intubation?

Published by Charlie Davidson on

What drugs are given before intubation?

[4] Common sedative agents used during rapid sequence intubation include etomidate, ketamine, and propofol. Commonly used neuromuscular blocking agents are succinylcholine and rocuronium. Certain induction agents and paralytic drugs may be more beneficial than others in certain clinical situations.

What is neonatal intubation?

Introduction. Neonates in Intensive Care often require intubation and mechanical ventilation. Elective intubation refers to the practice of inserting an endotracheal tube (ETT) for the purpose of providing mechanical ventilation in a non-emergency setting, i.e. the neonate is not requiring resuscitation.

Why is atropine given before intubation?

Atropine is occasionally used as a premedication. Its anticholinergic effects reduce ACH-mediated bradycardia that can accompany endotracheal intubation. Etomidate is given IV over 30 to 60 seconds.

Are you awake during intubation?

The two arms of awake intubation are local anesthesia and systemic sedation. The more cooperative your patient, the more you can rely on local; perfectly cooperative patients can be intubated awake without any sedation at all. More commonly in the ED, patients will require sedation.

Can an infant be intubated?

—Newborns admitted to the neonatal intensive care unit (NICU) frequently require laryngoscopy and endotracheal intubation. These procedures may be associated with detrimental physiologic alterations, including bradycardia, hypoxemia, systemic hypertension, and increased intracranial pressure (ICP).

Why would you intubate a newborn?

Endotracheal intubation, a common procedure in newborn care, is associated with pain and cardiorespiratory instability. The use of premedication reduces the adverse physiological responses of bradycardia, systemic hypertension, intracranial hypertension and hypoxia.

Do you need premedication for endotracheal intubation in newborns?

All newborn infants, therefore, should receive analgesic premedication for endotracheal intubation except in emergency situations.

What’s the best premedication protocol for newborns?

Based on current evidence, an optimal protocol for premedication is to administer a vagolytic (intravenous [IV] atropine 20 μg/kg), a rapid-acting analgesic (IV fentanyl 3 μg/kg to 5 μg/kg; slow infusion) and a short-duration muscle relaxant (IV succinylcholine 2 mg/kg).

What are the effects of premedication in newborns?

Pulmonary hypertension leading to right ventricular failure during intubation has been well described in adults (15), but pulmonary artery pressures have not been measured in newborn infants during intubation. WHAT ARE THE EFFECTS OF PREMEDICATION ON THE PHYSIOLOGICAL RESPONSES?

Which is the best drug for intubation induction?

Morphine should remain our drug of first choice for intubation induction because we have most experience with it and there is no evidence that any of the other drugs are clearly better. In all situations where there is time to draw up the medications, babies for intubation should be pre- medicated in the following way.

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