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Updated: May 18, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Pediatric airway management: current practices and future directions
Rani A Sunder1, Dawit T Haile, Patrick T Farrell
1Division of Pediatric Anesthesiology, Washington University at St Louis, St Louis, MO 63105, USA.
Managing difficult pediatric airways requires structured approaches. Advances in devices and simulation, alongside dedicated expert teams, aim to improve patient safety and reduce adverse events in pediatric airway management.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
Background:
- Pediatric airway management presents unique challenges, particularly for non-specialists.
- A lack of structured algorithms for unexpected difficult pediatric airways has been noted.
- Recent advancements offer potential solutions, but their roles are still developing.
Purpose of the Study:
- To review recent advancements in pediatric difficult airway management.
- To highlight the importance of structured algorithms and expert teams.
Main Methods:
- Review of recent literature on pediatric airway devices and simulation technology.
- Discussion of a step-wise algorithm based on the Difficult Airway Society (DAS) adult protocol.
Main Results:
- Development of pediatric-specific extra-glottic devices and new laryngoscopes.
- Simulation technology is a valuable tool for skill acquisition in airway management.
- A step-wise algorithm adapted from adult protocols shows promise.
Conclusions:
- Institutions should consider establishing dedicated Difficult Airway Services with expert teams.
- A multidisciplinary approach integrating new devices, algorithms, and simulation is crucial.
- The goal is to minimize serious adverse events in pediatric airway management.
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