RT Book, Section
A1 Georgolios, Alexandros
A1 Johnson, Charles
A1 Bagwell, Charles
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100432742
T1 Airway Endoscopy and Pathology, and Tracheotomy
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesspediatrics.mhmedical.com/content.aspx?aid=1100432742
RD 2024/04/18
AB A  child's  airway  is  shorter  and  smaller  in  caliber  than  the  adult's,  the  larynx  is  placed  more  anterior,  and  the  structures  are  more  collapsible.  Prior  to  ages  8  to  10  years,  the  smallest  portion  of  the  airway  is  the  subglottic  trachea.Stridor  merits  immediate  investigation  and  is  nearly  always  an  indication  for  airway  endoscopy.The  principal  advantage  of  rigid  over  flexible  bronchoscopy  involves  better  control  of  the  airway,  but  also  allows  access  to  instruments,  removal  of  foreign  bodies,  or  more  effective  suctioning  capability.Rigid  and  flexible  bronchoscopy  are  complementary  techniques  used  in  various  circumstances  to  assess  airway  anatomy  and  function,  in  some  cases  concurrently.In  the  rare  urgent  case  when  establishment  of  an  airway  is  critical  and  endotracheal  intubation  fails,  the  treatment  of  choice  in  children  is  needle  access  of  the  trachea  with  a  large-bore  angiocath.Retention  sutures  are  placed  parallel  to  the  proposed  site  for  a  pediatric  tracheotomy  incision  in  mid-trachea.  These  can  provide  exposure  of  the  trachea  and  allow  replacement  in  the  case  of  accidental  tracheal  dislodgement  in  the  early  postoperative  period.There  are  various  and  numerous  challenging  issues  for  the  parents  after  the  patient  is  discharged  home  with  a  new  tracheostomy.  These  may  include  skin  and  stoma  care,  suctioning,  humidification  and  routine  changes  of  the  tracheostomy  ties  and  the  tracheostomy  tube  itself,  and  education  for  emergent  situations.