Recognizing and Managing the Difficult Pediatric Airway: Difference between revisions

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* remember of gastric distension. If present, empty stomach with an orogastric tube;
* remember of gastric distension. If present, empty stomach with an orogastric tube;


If none of the above measures work, place a supraglottic airway device (SAD). If adequate ventilation is obtained and the surgery can be safely conducted with the SAD, proceed. However if tracheal intubation is needed, use the SAD as a conduit to fiberoptic intubation. Nevertheless, if SAD fails to grant adequate ventilation, proceed to CICO scenario (cannot intubate, cannot oxygenate) or awake the patient if SpO2 permits (slow decline with stable hemodynamics). In CICO scenario, front-of-neck access must be made preferably by the surgery or ENT team. In the absence of them, anesthesiologist must perform a cricothyroidotomy by his/her preferable technique.
If none of the measures above work, place a supraglottic airway device (SAD). If adequate ventilation is obtained and the surgery can be safely conducted with the SAD, proceed. However if tracheal intubation is needed, use the SAD as a conduit to fiberoptic intubation. Nevertheless, if SAD fails to grant adequate ventilation, proceed to CICO scenario (cannot intubate, cannot oxygenate) or awake the patient if SpO2 permits (slow decline with stable hemodynamics). In CICO scenario, front-of-neck access must be made preferably by the surgery or ENT team. In the absence of them, anesthesiologist must perform a cricothyroidotomy by his/her preferable technique.


=== Easy bag-mask ventilation, difficult direct laryngoscopy ===
=== Easy bag-mask ventilation, difficult direct laryngoscopy ===