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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 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), asthma, and hypotension.
- Confirmation of tracheal intubation should always include use of an ETCO2 device.
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Appreciation of pediatric airway conditions is based on the anatomy of the airway. Figures 23–1A and B are 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 obstruction (Fig. 23–2). Some textbooks ...