Improving neonatal intubation safety: A journey of a thousand miles

T. Sawyer*, E. Foglia, L.D. Hatch, A. Moussa, A. Ades, L. Johnston, A. Nishisaki | JNPM 2017;

Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is difficult and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine. In this commentary we review key elements in the journey to improve neonatal intubation safety. We begin with a review of intubation success rates and complications. Then, we discuss the importance of intubation training. Next, we examine quality improvement efforts and patient safety research to improve neonatal intubation safety. Finally, we evaluate new tools which may improve success rates, and decrease complications during neonatal intubation.

*Corresponding Author: 

Taylor Sawyer, DO, Med, University of Washington School of Medicine, 1959 NE Pacific St, RR451 HSB, Box 356320, Seattle, WA 98195 6320, USA. Tel.: +1 206 543 3200; Fax: +1 206 543 8926; E-mail: