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A Primer for Pediatric Emergency Front-of-the-Neck Access

Joana Berger-Estilita1, Vivian Wenzel, Markus M Luedi

  • 1From the Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

A&A Practice
|April 6, 2021
PubMed

Insights

Difficult pediatric airway emergencies, known as "cannot intubate, cannot oxygenate" events, are rare but dangerous. This study reviews emergency front-of-the-neck access strategies for pediatric airway management.

Area of Science:

  • Pediatric Anesthesiology
  • Emergency Medicine
  • Airway Management

Background:

  • Uncommon "cannot intubate, cannot oxygenate" scenarios in children carry high risks.
  • Effective management requires preparedness and specific algorithms.
  • Emergency tracheal access is often the final step in difficult pediatric airway algorithms.

Purpose of the Study:

  • To provide an overview of pediatric emergency front-of-the-neck access (FONA) strategies.
  • To offer a structured approach for managing these critical airway events.
  • To enhance practitioner preparedness for rare but severe pediatric airway emergencies.

Main Methods:

  • Review of existing literature on pediatric FONA techniques.
  • Analysis of clinical assessment and anticipatory planning strategies.
  • Development of a management framework for emergency pediatric airway access.

Main Results:

  • FONA is a critical intervention in "cannot intubate, cannot oxygenate" situations.
  • Preparedness and structured algorithms improve outcomes.
  • Specific FONA techniques and a management framework are essential for practitioners.

Conclusions:

  • Practitioners need specialized knowledge and training for pediatric FONA.
  • A structured approach to FONA management is crucial for rare pediatric airway emergencies.
  • Effective FONA strategies can mitigate poor outcomes in critical pediatric airway events.

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