Pediatric Airway Management

Course overview

Objectives Describe the challenges associated with pediatric airway management Explain the anatomical differences pediatrics have Describe tips and tricks for the field Content 1 Airway Anatomy 1 Sinuses 1 Frontal 2 Sphenoid 3 Ethmoid 4 Maxillary 2 Upper Airway Tract 1 Nose 2 Mouth and Oral Cavity 3 Jaw 4 Pharynx 1 Nasopharynx 2 Oropharynx 3 Hypopharynx 4 Laryngopharynx 1 Vallecula 1 Pyriform Sinus 5 Larynx 1 Cartilages 1 epiglottis 2 arytenoid cartilage 1 corniculate cartilage 2 cuneiform cartilage 3 posterior arytenoids 3 vocal cords 1 false vocal cord 2 true vocal cord 4 thyroid cartilage 5 cricoid ring 1 arch of cricoid cartilage 2 lamina of cricoid cartilage 3 cricothyroid membrane ligament 2 Bone 1 Hyoid bone 1 Hyo epiglottic ligament 3 Jugular notch 4 Lower Airway Tract 1 Trachea Spatial relationship to esophagus 2 Carina Angle of Louis 3 Bronchi 4 Lungs 1 Bronchioles 1 bronchial smooth muscle 2 beta two adrenergic receptors 2 Pulmonary cilia 3 Alveoli Surfactant 5 Support Structures 1 Chest Cage 1 Ribs 2 Muscles of respiration 1 intercostal muscles 2 diaphragm 3 Pleura 1 parietal pleura 2 visceral pleura 2 Phrenic nerve 3 Mediastinum 2 Airway Assessment 1 Purpose 1 Identify inadequate airway 2 Identify an unstable airway 3 Identify potentially difficult airways 2 Procedure 1 Gag Reflex 2 Airway obstruction 1 Soft tissue obstruction 2 Foreign bodies 3 Complete and incomplete 4 Upper vs Lower 3 Work of breathing 4 Laryngospasm 5 Laryngeal edema 6 Penetrating injuries 3 Anticipating the difficult airway 1 Trauma bleeding 2 Vomiting 3 History 4 Mouth opening 5 Mandibular length 6 Mallampati classifications 7 Obstructions 8 Neck mobility 9 Facial hair 3 Techniques of assuring a patent airway 1 Manual airway maneuvers 2 Mechanical airway devices 3 Relief of Foreign Body Airway Obstruction 1 Refer to current American Heart Association guidelines 2 Removal of foreign body airway obstructions using direct laryngoscopy 1 Purpose 2 Indications 3 Contraindications 4 Complications 5 Procedure 6 Limitation 3 Airway suctioning 1 Review and elebaorate on the upper airway suctioning material from the EMR EMT and AEMT levels 2 Tracheobronchial Suctioning 1 purpose 2 indications 3 contraindications 4 complications 5 procedure 6 limitation 4 Blind insertion airway devices 5 Endotracheal intubation 1 Direct laryngoscopy visualized 1 Purpose 2 Indications 3 Contraindications 4 Complications 5 Procedure including confirmation techniques 6 Limitations 2 Non visualized 1 Nasal 1 purpose 2 indications 3 contraindications 4 complications 5 procedure including confirmation techniques 6 limitations 2 Digital 1 purpose 2 indications 3 contraindications 4 complications 5 procedure including confirmation techniques 6 limitations 3 Lighted stylet 1 purpose 2 indications 3 contraindications 4 complications 5 procedure including confirmation techniques 6 limitations 4 Fiber optic Shikaini Seeing Optical Stylet SOS Glide scope 1 purpose 2 indications 3 contraindications 4 complications 5 procedure including confirmation techniques 6 limitations 6 Percutaneous cricothyrotomy 1 Purpose 2 Indications 3 Contraindications 4 Complications 5 Procedure including confirmation techniques 6 Limitations 4 Consider age related variations in pediatric and geriatric patients 1 See Special Patient Populations section