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Simple method for obtaining the optimal laryngoscopic view in children: A prospective observational study
Eun-Hee Kim1, Sang-Hwan Ji1, In-Kyung Song1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
The American Journal of Emergency Medicine
|February 1, 2017
Summary
Proper head positioning using a pillow significantly improves laryngeal visualization during pediatric direct laryngoscopy. Aligning the auditory meatus and sternal notch enhances glottic view and eases intubation.
Area of Science:
- Anesthesiology
- Pediatric Airway Management
Background:
- Head and neck positioning critically impacts laryngeal visualization during laryngoscopy.
- Traditional head-flat positioning in infants may not always yield optimal laryngeal views.
Purpose of the Study:
- To determine if aligning the external auditory meatus and sternal notch with an individualized pillow height improves laryngeal visualization during direct laryngoscopy in pediatric patients.
Main Methods:
- 49 pediatric patients (3-6 years) undergoing general anesthesia were studied.
- The percentage of glottic opening and laryngoscope handling ease were assessed before and after head positioning with a pillow.
Main Results:
- Pillow adjustment to align auditory meatus and sternal notch significantly increased the percentage of glottic opening score (50 to 90; p<0.0001).
- Laryngoscope handling ease also significantly improved (7 to 9; p<0.0001).
- No significant complications occurred during intubation.
Conclusions:
- Aligning the external auditory meatus and sternal notch via pillow positioning leads to superior laryngoscopic visualization in pediatric patients.
- This technique simplifies the laryngoscopic procedure for pediatric intubation.
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