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Paediatr Anaesth. 2019 Oct;29(10):985-992. doi: 10.1111/pan.13716. Epub 2019 Sep 2.

A framework for the management of the pediatric airway.

Author information

1
Department of Anaesthesia, Royal Children's Hospital Aberdeen and School of Medicine, University of Aberdeen, Aberdeen, UK.
2
Department of Anesthesia, McGill University Health Center, Montreal Children's Hospital, Montreal, QC, CA.
3
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
4
Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland.
5
Consultant Anaesthetist, Starship Children's Hospital, Auckland, New Zealand.
6
Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.
7
Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
8
Anestesióloga pediátrica, Miembro del comité de Anestesia Pediátrica, Sociedad Colombiana de Anestesiología y Reanimación, Anestesióloga del Instituto Rooselvelt, Bogotá, DC, Colombia.
9
Medical School, The University of Western Australia, Perth, WA, Australia.
10
Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia.
11
Telethon Kid's Institute, Perth, WA, Australia.

Abstract

Critical airway incidents in children are a frequent problem in pediatric anesthesia and remain a significant cause of morbidity and mortality. Young children are at particular risk in the perioperative period. Delayed management of airway obstruction can quickly lead to serious complications due to the short apnea tolerance in children. A simple, time critical, and pediatric-specific airway management approach combined with dedicated teaching, training, and frequent practice will help to reduce airway-related pediatric morbidity and mortality. There is currently no pediatric-specific universal framework available to guide practice. Current algorithms are modifications of adult approaches which are often inappropriate because of differences in age-related anatomy, physiology, and neurodevelopment. A universal and pragmatic approach is required to achieve acceptance across diverse pediatric clinicians, societies, and groups. Such a framework will also help to establish minimum standards for pediatric airway equipment, personnel, and medications whenever pediatric airway management is required.

KEYWORDS:

airway; children; framework

PMID:
31402534
DOI:
10.1111/pan.13716

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