Duration of intubation attempts during neonatal resuscitation.
OBJECTIVE
Since the American Academy of Pediatrics Neonatal Resuscitation Program recommends that intubation should be completed in approximately 20 seconds, we measured the duration of neonatal intubation attempts by different operators, using video recordings of neonatal resuscitations.


METHODS
We used an ongoing quality improvement program to measure the duration of intubation attempts.


RESULTS
The mean duration for the 50 successful intubations, including 6 for meconium, was 27.3 seconds compared with 29.8 seconds for unsuccessful attempts (not significant). Fifteen infants were successfully intubated on each of the first and second attempts, 10 on the third attempt, and 10 required more than 3 attempts. The mean duration of successful intubation was 31.9 seconds for PL-1's, 27.5 seconds for PL-2/3's, and 23.6 seconds for fellows. Overall intubations were more successful for a duration of 30 seconds or less compared with 20 seconds or less (72% vs 38%; chi(2)=10.3, P=.001). No infant decompensated between 20 and 30 seconds. Ten successful and 12 failed attempts took longer than 40 seconds.


CONCLUSIONS
We recommend that a duration of 30 seconds is a reasonable guideline for neonatal intubation during resuscitation.
Lane
Brian
B
Department of Pediatrics, UCSD Medical Center, San Diego, California 92103, USA.
Finer
Neil
N
Rich
Wade
W
D002983:Clinical Competence; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000379:methods / Q000592:standards*; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial / Q000379:methods / Q000592:standards*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D013996:Time and Motion Studies; D014741:Video Recording