Scholarlink

Background <p>Tracheal intubation in very low birth weight (VLBW) infants is a high-risk procedure associated with tracheal intubation adverse events (TIAEs). Premedication for non-emergent intubations typically includes a vagolytic and analgesic agent. Rapid sequence intubation (RSI), defined as premedication with a vagolytic, analgesic, and paralytic agent, is used to enhance procedural safety and reduce complications. Premedication without paralysis was used for infants receiving surfactant with immediate extubation.</p> Objective <p>To increase the use of premedication and RSI in VLBW infants and reduce adverse events.</p> Methods <p>A QI initiative targeting VLBW infants at a level IV NICU undergoing non-emergent intubations. Interventions included forming a multidisciplinary team, education, and implementing an EHR-pathway with embedded orders.</p> Results <p>Premedication use increased from 25.7% to 93.4%, and RSI use from 14.6% to 77.3%. TIAEs decreased from 41.4% to 14.4%, and severe desaturations from 32% to 11.2%.</p> Conclusions <p>Standardizing premedication practices, including RSI,&#xa0;can improve neonatal safety.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Reducing tracheal intubation adverse events and severe desaturations by increasing intubation premedication use in infants <1500 g: a quality improvement initiative

  • 期刊论文

  • 发表日期：

    2025年11月24日

查看全文
  • Josh Daniel,
  • Lindsay C. Johnston,
  • Cassandra DeMartino,
  • Eleanor Blythe,
  • Sarah Beres,
  • Cathleen Garcia,
  • Noa Fleiss

摘要

Background

Tracheal intubation in very low birth weight (VLBW) infants is a high-risk procedure associated with tracheal intubation adverse events (TIAEs). Premedication for non-emergent intubations typically includes a vagolytic and analgesic agent. Rapid sequence intubation (RSI), defined as premedication with a vagolytic, analgesic, and paralytic agent, is used to enhance procedural safety and reduce complications. Premedication without paralysis was used for infants receiving surfactant with immediate extubation.

Objective

To increase the use of premedication and RSI in VLBW infants and reduce adverse events.

Methods

A QI initiative targeting VLBW infants at a level IV NICU undergoing non-emergent intubations. Interventions included forming a multidisciplinary team, education, and implementing an EHR-pathway with embedded orders.

Results

Premedication use increased from 25.7% to 93.4%, and RSI use from 14.6% to 77.3%. TIAEs decreased from 41.4% to 14.4%, and severe desaturations from 32% to 11.2%.

Conclusions

Standardizing premedication practices, including RSI, can improve neonatal safety.