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The relatively large tongue in an unconscious infant is the most common cause of airway obstruction. An oral or nasopharyngeal airway can resolve the problem.
Overinflation with bag-mask ventilation (BMV) can result in gastric distention and restrict lung expansion. This can be resolved by placing a nasogastric tube.
A self-inflating bag does not deliver blow-by oxygen when it is not being compressed.
Before using sedatives and paralytics for tracheal intubation, be sure to assess for conditions that may be associated with a “difficult airway.”
Selection of a sedating agent for tracheal intubation is based on recognition of three specific clinical conditions: head trauma (increased intracranial pressure [ICP]), asthma, and hypotension.
Confirmation of tracheal intubation should always include use of an end-tidal CO2 (ETCO2) device.
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Appreciation of pediatric airway conditions is based on the anatomy of the airway. Figure 17-1(A and B) shows lateral neck x-rays of a child with croup. The patient's nose (anterior) is on the right and the occiput (posterior) is on the left. Note the lordotic (extended) cervical spine vertebral bodies.
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Pediatric Airway Differences
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Physical factors that differ between adults and children account for the airway differences that are clinically important. The most important of these is a smaller airway diameter. Smaller airways with the same degree of airway edema result in proportionately greater ...