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The Pediatric Airway

The first challenge in pediatric airways is overcoming the anatomic challenges associated with younger pediatric patients. A more anteriorly positioned larynx and a large head-to-body ratio result in more acute angles between the oropharynx and the larynx. The tongue and epiglottis tend to be more prominent and soft, making displacement visualizing the vocal cords more difficult. The cricoid cartilage is the narrowest part of the airway, so the tube may pass the cords but may be difficult to advance beyond that. Finally, the relatively small size of the cricothyroid membrane serves as a relative contraindication to traditional cricothyrotomy in the event that airway management from above the…

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 The Pediatric Airway: Pearls and Pitfalls

Airway management is one of the most important skills in the evaluation ofa child in distress. In a critically ill child, the evaluation begins with establishing a patent airway. Children are not small adults, and there are many anatomical and physiological differences, as well as a myriad of etiologies precipitating the event that may necessitate immediate airway management.

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Difficult to Ventilate and Oxygenate: The Pediatric Airway Overview

Besides anatomic differences, there are physiologic differences that impact the management of the pediatric airway. Pediatric patients have a higher oxygen demand and oxygen consumption. Combined with smaller airway volumes, the higher oxygen demand and consumption results in lower functional residual capacity and a smaller oxygen reserve. Additionally, abdominal distension, most commonly due to too much BVM ventilation prior to intubation, can lead to decreased functional residual capacity and O2 desaturation... Management of the airway should always include preparation for possible difficulties. Familiarizing yourself with the location of the necessary equipment and a step-wise assessment of your equipment beforehand is essential.

The Pediatric Airway and Rapid Sequence Intubation

Currently, pediatric airway emergencies that require a secure and advanced airway range from 0.6 to 3.3 per 1,000 cases. The median age often varies by institution; however, the highest risk patients commonly are younger than 12 months old.