Ellen de Kort

81 Sedation assessment for neonatal intubation 5 Parameter for start intubation Start intubation Consequences insufficient sedation/relaxation Time 1-2 min after preoxygenation Relaxation At disappearance of muscle fasciculations and begin of muscle flaccidity Up to 4 extra doses of suxamethonium Time 1 min after infusion Sedation No reaction to heel rubbing None mentioned Lowest sedation 2 1 Movement on slight touch Spontaneous movements Effective sedation = score 3 or 4 2 1 Normal tone Hypertonic Effective relaxation = score 3 or 4 0 1 2 No sedation/no pain signs Irritable or crying at intervals, consolable High-pitched or silent continuous cry, inconsolable No sedation/no pain signs Restless, squirming, awakens frequently Arching, kicking, constantly awake or arouses minimally/ no movement (not sedated) No sedation/no pain signs Any pain expression intermittent Any pain expression continual No sedation/no pain signs Intermittent clenched toes, fists, finger splay, body is not tense Continual clenched fists, toes, finger splay, body is tense No sedation/no pain signs 10-20% increase from baseline, SaO2 76-85% with stimulation – quick recovery 20% increase from baseline, SaO2 < 75% with stimulation, slow recovery Good sedative state = total score on all 5 items -7 to -3