Newborns should be receiving premedication before elective intubation

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dc.contributor.authorRaban, Moegammad Shukri
dc.contributor.authorJoolay, Yaseen
dc.contributor.authorHorn, Alan Richard
dc.contributor.authorHarrison, Michael Charles
dc.date.accessioned2021-10-08T07:20:28Z
dc.date.available2021-10-08T07:20:28Z
dc.date.issued2014
dc.description.abstractBACKGROUND: Intubation is a common neonatal procedure. Premedication is accepted as a standard of care, but its use is not universal and wide variations exist in practice. OBJECTIVE: To evaluate current practices for premedication use prior to elective neonatal intubation in South Africa (SA). METHOD: We invited 481 clinicians to participate in a cross-sectional web-based survey. RESULTS: We received responses from 28.3% of the clinicians surveyed; 54.1% were from the private sector and 45.9% from the state sector. Most respondents worked in medium-sized neonatal units with six to ten beds. Most paediatricians (76.0%) worked in the private sector, and 78.6% of neonatologists in the state sector. Premedication was practised by 71.9% of the respondents, but only 38.5% of neonatal units had a written policy. Sedatives were used for premedication by 63.2% of the respondents. Midazolam (41.5%), morphine (34.0%) and ketamine (20.8%) were most commonly used. Muscle relaxants and atropine were not routinely administered. Suxamethonium was the muscle relaxant of choice. Varied combinations of agents or single agents were used. Midazolam used alone was the preferred option. CONCLUSION: This first survey of premedication for neonatal intubation in SA revealed variations in practice, with a minority of clinicians following a written policy. The findings can be used to benchmark practice and inform the design of local collaborative trials aimed at determining optimal premedication prior to neonatal intubation. The survey demonstrates clinicians' reluctance to participate in surveys, suggesting a need for a national collaborative network to obtain representative data.
dc.identifier.apacitationRaban, M. S., Joolay, Y., Horn, A. R., & Harrison, M. C. (2014). Newborns should be receiving premedication before elective intubation. <i>South African Medical Journal</i>, 104(12), 846 - 177. http://hdl.handle.net/11427/34926en_ZA
dc.identifier.chicagocitationRaban, Moegammad Shukri, Yaseen Joolay, Alan Richard Horn, and Michael Charles Harrison "Newborns should be receiving premedication before elective intubation." <i>South African Medical Journal</i> 104, 12. (2014): 846 - 177. http://hdl.handle.net/11427/34926en_ZA
dc.identifier.citationRaban, M.S., Joolay, Y., Horn, A.R. & Harrison, M.C. 2014. Newborns should be receiving premedication before elective intubation. <i>South African Medical Journal.</i> 104(12):846 - 177. http://hdl.handle.net/11427/34926en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Raban, Moegammad Shukri AU - Joolay, Yaseen AU - Horn, Alan Richard AU - Harrison, Michael Charles AB - BACKGROUND: Intubation is a common neonatal procedure. Premedication is accepted as a standard of care, but its use is not universal and wide variations exist in practice. OBJECTIVE: To evaluate current practices for premedication use prior to elective neonatal intubation in South Africa (SA). METHOD: We invited 481 clinicians to participate in a cross-sectional web-based survey. RESULTS: We received responses from 28.3% of the clinicians surveyed; 54.1% were from the private sector and 45.9% from the state sector. Most respondents worked in medium-sized neonatal units with six to ten beds. Most paediatricians (76.0%) worked in the private sector, and 78.6% of neonatologists in the state sector. Premedication was practised by 71.9% of the respondents, but only 38.5% of neonatal units had a written policy. Sedatives were used for premedication by 63.2% of the respondents. Midazolam (41.5%), morphine (34.0%) and ketamine (20.8%) were most commonly used. Muscle relaxants and atropine were not routinely administered. Suxamethonium was the muscle relaxant of choice. Varied combinations of agents or single agents were used. Midazolam used alone was the preferred option. CONCLUSION: This first survey of premedication for neonatal intubation in SA revealed variations in practice, with a minority of clinicians following a written policy. The findings can be used to benchmark practice and inform the design of local collaborative trials aimed at determining optimal premedication prior to neonatal intubation. The survey demonstrates clinicians' reluctance to participate in surveys, suggesting a need for a national collaborative network to obtain representative data. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 12 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - Newborns should be receiving premedication before elective intubation TI - Newborns should be receiving premedication before elective intubation UR - http://hdl.handle.net/11427/34926 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34926
dc.identifier.vancouvercitationRaban MS, Joolay Y, Horn AR, Harrison MC. Newborns should be receiving premedication before elective intubation. South African Medical Journal. 2014;104(12):846 - 177. http://hdl.handle.net/11427/34926.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue12
dc.source.journalvolume104
dc.source.pagination846 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.8305
dc.subject.otherMuscles
dc.subject.otherMorphine Derivatives
dc.subject.otherMidazolam
dc.subject.otherAtropine Derivatives
dc.subject.otherKetamine
dc.subject.otherBeds
dc.subject.otherData Collection
dc.subject.otherIntubation
dc.subject.otherPremedication
dc.titleNewborns should be receiving premedication before elective intubation
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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