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Published on: September 28, 2022
Advances in Emergent Airway Management in Pediatrics
Kelsey A Miller1, Joshua Nagler1
1Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
Insights
Pediatric endotracheal intubation can be challenging. This article provides strategies for pediatric airway management, alternative approaches, and tips for maintaining procedural skills in emergency care.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Anesthesiology
Background:
- Airway management is crucial for critically ill pediatric patients.
- Pediatric endotracheal intubation is infrequently performed in emergency settings, leading to skill decay.
- Understanding pediatric-specific anatomy and physiology is key for successful airway management.
Purpose of the Study:
- To offer strategies for effective pediatric airway management.
- To review alternative airway management techniques for difficult airways.
- To provide recommendations for maintaining procedural competency.
Main Methods:
- Review of pediatric airway anatomy and physiology.
- Discussion of noninvasive ventilation and videolaryngoscopy as alternative methods.
- Recommendations for skill maintenance strategies.
Main Results:
- Children have distinct airway differences impacting intubation.
- Noninvasive ventilation and videolaryngoscopy offer valuable alternatives.
- Regular training and simulation are essential for skill preservation.
Conclusions:
- Effective pediatric airway management requires tailored strategies.
- Alternative techniques can improve outcomes in difficult airway scenarios.
- Continuous education and practice are vital for providers managing pediatric airways.
Abstract:
Airway management is the cornerstone to resuscitation efforts for many critically ill pediatric patients presenting for emergency care. Pediatric endotracheal intubation is uncommon in emergency medicine, making it challenging to maintain comfort with this critical procedure. This article offers strategies to facilitate pediatric airway management by addressing predictable anatomic and physiologic differences in children. Also reviewed are alternative approaches to airway management (eg, noninvasive ventilation and videolaryngoscopy) that might be used in cases of recognized difficult airways. Finally, recommendations for maintaining procedural skills in providers who may have limited clinical exposure to critically ill children requiring airway interventions are provided.
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