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J Neonatal Perinatal Med. 2017;10(2):125-131. doi: 10.3233/NPM-171686.

Improving neonatal intubation safety: A journey of a thousand miles.

Author information

1
Seattle Children's Hospital and University of Washington School of Medicine, Department of Pediatric, Division of Neonatology, Seattle, WA, USA.
2
The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, Department of Pediatric, Division of Neonatology, Philadelphia, PA, USA.
3
Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Department of Pediatric, Division of Neonatology, Nashville, TN, USA.
4
Université de Montréal, Department of Pediatric, Division of Neonatology, Montréal, QC, Canada.
5
Yale-New Haven Hospital and Yale School of Medicine, Department of Pediatric, Division of Neonatology, New Haven, CT, USA.

Abstract

Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is difficult and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine. In this commentary we review key elements in the journey to improve neonatal intubation safety. We begin with a review of intubation success rates and complications. Then, we discuss the importance of intubation training. Next, we examine quality improvement efforts and patient safety research to improve neonatal intubation safety. Finally, we evaluate new tools which may improve success rates, and decrease complications during neonatal intubation.

KEYWORDS:

Endotracheal intubation; intubation associated adverse event; neonatal intubation; patient safety; quality improvement; tracheal intubation

PMID:
28409758
DOI:
10.3233/NPM-171686
[Indexed for MEDLINE]

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