INSURE Video

[hehady]

Would you kindly help me to get access to teaching video on how to give surfactant via 'INSURE Technique'

[Stefan Johansson]

I don't have a video clip of the INSURE technique, but it is not complicated to explain.

We use INSURE rather frequently for RDS-treatment/surfactant installation, in >27 week infants, with Xray-diagnosis of RDS, adequate nasal CPAP-pressure (which we consder 4-5 cm to be) and an a/A-ratio of <0.22.

1. Loading dose of teofyllin (5 mg/kg iv)

2. Slow injection of morphine before intubation (0.15-0.2 mg/kg iv)

3. Pentobarbital immediate before intubation (2-5 mg/kg iv).

4. Oral intubation. Don't push the tube to far down to avoid bronchial intubation. Check tube position clinically by listening for equal to the lungs. Fixate the tube by a single piece of tape, or hold the tube/infant's head with one hand.

5. Intratracheal administation of surfactant (100-200 mg/kg).

6. Naloxone iv (0.1 mg/kg). Wait and assist the infant's breathing until he/she breathe well and saturation >90%

7. Extubate and continue with nasal CPAP.

[hehady]

Thanks Stefan for the reply. I have the details of the techinque, what I realy wanted is a teaching video for residents and fellows as I'm preparing a course on NCPAP and this could be of great help. I've seen one in one of the ESPR meetings by a Swedish colleague, but I do not how to access.

[Stefan Johansson]

I see! That particular video clip is copyright-protected.

Maybe we can make a (second) video for educational purposes with permissions from parents etc.

Should we aim at collecting educational videos here at 99nicu?!

[hehady]

Dear Dr Stefan: Some educational videos can be purchased, Some are free. It is a good idea to help others to access these videos through 99 nicu forum