Duration of intubation attempts during Neonatal Resuscitation

Improving neonatal intubation safety: A journey of a thousand miles

“…These studies have consistently identified experience level and provider discipline as significant factors associated with intubation success (Fig. 1) [1][2][3][4][5][6][7][8]. Experienced providers, such as attending neonatologists, have the highest success rates of around 64%.…”

“…1. Neonatal intubation first attempt success rates, presented as mean ± standard deviation, by provider type based on pooled data from eight published single center and multicenter observational studies (8,066 total intubations) [1][2][3][4][5][6][7][8]. First attempt success rates by provider type are as follows: pediatric residents 42 ± 9%, NICU non-physician clinicians (nurse practitioners, physician assistants, respiratory therapists and transport nurses) 52 ± 9%, NICU fellow 63 ± 14%, NICU attending 64 ± 16%.…”

Premedication for Nonemergency Endotracheal Intubation in the Neonate

“…Several studies that evaluated the success rate of neonatal endotracheal intubations have reported that successful intubations frequently require more than 1 attempt and are rarely accomplished within the currently recommended time frame. [1][2][3] Many failed attempts can be attributed to suboptimal intubating conditions. Excellent intubating conditions are characterized by good jaw relaxation, open and immobile vocal cords, and suppression of pharyngeal and laryngeal reflexes assessed by the absence of coughing or diaphragmatic movements in response to intubation.…”

Old school

“…Nationally 50% of senior pediatric residents cannot intubate a newborn, and many neonatal fellows have never inserted a chest tube. [1][2][3] What is going to happen when they go out in the real world?…”