Enhancing Safety in Pediatric Airway Management: An Integrative Review for Perioperative Settings

Pediatric airway management presents unique challenges that require specialized knowledge, preparation, and coordinated teamwork. This integrative review synthesizes current evidence to guide perioperative teams, particularly Certified Registered Nurse Anesthetists (CRNAs) and perioperative nurses, in promoting safety and readiness when caring for pediatric patients.

A structured literature review was conducted using PubMed, CINAHL, Embase, Cochrane Library, and Scopus. Studies were included if they addressed pediatric airway management techniques, education, or safety outcomes relevant to anesthesia and perioperative practice. Evidence was appraised using the Johns Hopkins Nursing Evidence-Based Practice framework.

Thirty-nine studies met the inclusion criteria and were analyzed for key themes in anatomy and physiology, complication prevention, equipment selection, and difficult airway management. Additional focus was placed on educational strategies such as simulation and continuing professional development.

The literature emphasizes that most perioperative pediatric adverse events are respiratory in nature and often preventable through early recognition, proper equipment preparation, and interdisciplinary communication. Evidence supports the use of video laryngoscopy, apneic oxygenation, and structured team training to improve outcomes. Simulation-based education enhances confidence, technical skills, and crisis response among CRNAs and perioperative staff.

Effective pediatric airway management requires both technical expertise and interprofessional collaboration. Regular review of pediatric airway anatomy, evidence-based algorithms, and structured team training can significantly enhance safety and provider confidence.