October 27, 200619 yr Would you kindly help me to get access to teaching video on how to give surfactant via 'INSURE Technique'
October 29, 200619 yr 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.
October 29, 200619 yr Author 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.
October 29, 200619 yr 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?!
October 30, 200619 yr Author 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
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