Airway Ultrasound: Applications in Pediatric Anesthesiology and Critical Care

The clinical uses and potential applications of point-of-care ultrasound (POCUS) have seen a significant increase in the practice of anesthesiology and critical care medicine. While initially used for regional anesthesia and vascular access, POCUS has since expanded to have significant applications for airway management and evaluation. Ultrasound has been effectively used to visualize the anatomical structures of the hypopharynx and anterior neck including the cricothyroid membrane, tracheal rings, esophagus, and aerated lung in a simple, rapid, and non-invasive manner. POCUS has demonstrated utility across multiple aspects of airway management including preoperative airway assessment, identification and evaluation of the difficult airway, confirmation of endotracheal intubation, verification of cuff position in relation to the cricoid ring, endotracheal tube depth, and localization of the cricothyroid membrane for emergency airway access. This educational review outlines the novel uses of POCUS in airway evaluation and management in various clinical scenarios with a focus on the pediatric-aged patient.