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Published on: January 17, 2011
Pediatric Difficult Airway Response Team Utilization in the Emergency Department: A Case Series
Geoffrey S Kelly1, Julia Kathleen Deanehan2, Nicholas M Dalesio3
1From the Departments of Emergency Medicine.
Insights
Pediatric difficult airway response team activations in the emergency department are rare. Most cases were successfully managed with standard equipment like direct laryngoscopy, avoiding invasive procedures.
Area of Science:
- Pediatric Emergency Medicine
- Airway Management
- Critical Care
Background:
- A multidisciplinary pediatric difficult airway team was established to manage hospital-wide airway emergencies.
- This study focuses on activations within the pediatric emergency department (PED).
Purpose of the Study:
- To characterize the indications and outcomes of difficult airway team activations in the PED.
- To evaluate the effectiveness of the pediatric difficult airway response team.
Main Methods:
- Retrospective, single-center cohort study of all PED difficult airway team activations from 2008 to 2018.
- Included patients aged 18 years or younger.
- Collected data on patient factors, PED context, airway interventions, and outcomes.
Main Results:
- Fifteen activations occurred over 10 years (1.4/year).
- Common indications included contaminated airways (47%) and prior difficult intubation (27%).
- All cases achieved definitive airway management, primarily via direct laryngoscopy (40%), with no emergency front-of-neck access required.
Conclusions:
- Difficult airways in the PED are infrequent.
- Standard airway management tools like direct laryngoscopy, video laryngoscopy, and supraglottic airways are effective.
Objectives:
A multidisciplinary pediatric difficult airway team was created at our institution to respond to hospital-wide airway emergencies. We report the characteristics, indications, and outcomes of these activations that occur in the pediatric emergency department (PED).
Methods:
Retrospective, single-center cohort study comprised all difficult airway team activations occurring in the PED from the program's inception in 2008 to 2018. Ages of ≤18 years were included. For each case, detailed information was abstracted, including patient factors, PED context and milieu, airway interventions, and airway outcomes.
Results:
There were 15 difficult airway response team activations in the PED during the study period, or 1.4 activations per year. The most common indications for activation were contaminated airways (n = 7; 47%) and history of difficult intubation (n = 4; 27%). Definitive airway management was successful in all cases, except for a single case where intervention was unnecessary. The most commonly performed definitive airway intervention was direct laryngoscopy (n = 6; 40%). There were no instances of emergency front-of-neck access.
Conclusions:
Difficult airways in the PED were uncommon. Most cases were resolved with familiar equipment including direct laryngoscopy, video laryngoscopy, and supraglottic airways.
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Introduction
The initial evaluation of a patient's respiratory system...