Airway management during pediatric resuscitation

Good airway management is fundamental to pediatric resuscitation. This review focuses on the anatomy of the infant and child airway, together with techniques and equipment required to open and maintain a child's airway in an emergency. Much of the knowledge has been available for many years but newer imaging techniques are allowing more accurate assessment of the child's airway anatomy and, in some cases, challenging traditional assumptions. In addition, recent technologies are facilitating the development of equipment, such as supra-glottic airway devices, cuffed tracheal tubes and video laryngoscopes that have the potential to simplify pediatric airway management. In some cases, this may bring the provision of safer definitive airway management into the hands of non-specialists, which will, in turn, allow the delivery of earlier and better care to the sick child. Such techniques are best used together with accurate monitoring to confirm the effectiveness of any intervention. In airway management, the use of expired carbon dioxide monitoring provides absolute confirmation that pulmonary ventilation is occurring and, when used together with the techniques and equipment described above, will reduce the potential for error and increase safety and survival.