Assessment and management of the predicted difficult airway in babies and children. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Baker, Paul A.; Navaratnarajah, Jamuna; Black, Ann E.
• Is Part Of: Anaesthesia and intensive care medicine. Volume 16:Issue 12(2015:Dec.)
• Page Start: 622
• Page End: 631
• Publication Date: 2015-12
• Subjects: Airtraq® -- C-Mac® -- difficult airway -- difficult intubation -- fibreoptic bronchoscope -- Glidescope® -- paediatric -- supraglottic airway devices -- TrueView® -- video laryngoscope; Anesthesiology -- Periodicals; Critical care medicine -- Periodicals; Anesthesia -- Periodicals; Intensive care -- Periodicals; Electronic journals; Periodicals; 617.9605
• DOI: 10.1016/j.mpaic.2015.09.002
• Languages: English
• ISSNs: 1472-0299

Abstract

Abstract: Although it is essential to take a history and examine every child prior to airway management, preoperative anticipation of a difficult airway is not totally reliable and therefore it is wise to be prepared for the unexpected difficult airway. Information about the airway can be gained from previous medical records, current history, physical examination and other tests. A natural consequence of airway assessment is development of an airway plan. Important anatomical and physiological features may be identified in an airway assessment which can then have a direct influence on the subsequent airway plan. Managing the predicted difficult airway is usually elective. This allows proper preparation of equipment, assistants, expertise and the environment required for the airway plan. This paper will discuss paediatric airway assessment, outline those features which contribute to airway difficulty, and identify indications and risk factors associated with various airway techniques. Key objectives for an airway management plan are to maintain oxygenation and avoid trauma. This involves adopting techniques that avoid hypoxia and provide a high success rate with minimum attempts.