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Contemporary issues in pediatric prehospital airway management

Henry E Wang1, Matthew Hansen2, Manish I Shah3

  • 1Department of Emergency Medicine, The Ohio State University, Columbus, Ohio, USA.

Expert Review of Respiratory Medicine
|September 18, 2025
PubMed

Insights

Paramedic airway management for children in emergencies is under-researched. New trials like the Pediatric Prehospital Airway Resuscitation Trial (Pedi-PART) aim to improve pediatric airway management practices by paramedics.

Area of Science:

  • Emergency medicine
  • Pediatric critical care

Background:

  • Prehospital airway management is crucial for paramedics.
  • Adult prehospital airway management has known pitfalls, but pediatric data is scarce.
  • Existing pediatric prehospital airway management research is limited, with only one trial from 25 years ago.

Purpose of the Study:

  • To highlight the need for improved pediatric airway management guidelines for paramedics.
  • To introduce the ongoing Pediatric Prehospital Airway Resuscitation Trial (Pedi-PART) as a critical step forward.

Main Methods:

  • Literature search of PubMed (2000-present) using keywords: 'children,' 'airway management,' 'intubation intratracheal,' 'Emergency Medical Services,' and 'paramedic.'
  • Review of adult prehospital airway management pitfalls and available pediatric data.
  • Identification of the Pedi-PART trial as a key ongoing study.

Main Results:

  • Adult prehospital intubation is associated with risks like tube misplacement, failed attempts, and interrupted compressions.
  • Supraglottic airways show promise as alternatives for adults.
  • There is a significant lack of recent research on pediatric prehospital airway management.

Conclusions:

  • Current prehospital pediatric airway management practices require updated guidance.
  • The Pedi-PART trial is expected to provide essential data to inform paramedic practices for pediatric airway management.
Abstract

Keywords:
Emergency medical servicesairway managementchildrenclinical trialsintubation intratrachealsupraglottic airways

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