Pediatric Airway Management

  1. Airway Anatomy
    1. Sinuses
      1. Frontal
      2. Sphenoid
      3. Ethmoid
      4. Maxillary
    2. Upper Airway Tract
      1. Nose
      2. Mouth and Oral Cavity
      3. Jaw
      4. Pharynx
        1. Nasopharynx
        2. Oropharynx
        3. Hypopharynx
        4. Laryngopharynx
          1. Vallecula
            1. Pyriform Sinus
      5. Larynx
        1. Cartilages
          1. epiglottis
          2. arytenoid cartilage
            1. corniculate cartilage
            2. cuneiform cartilage
            3. posterior arytenoids
          3. vocal cords
            1. false vocal cord
            2. true vocal cord
          4. thyroid cartilage
          5. cricoid ring
            1. arch of cricoid cartilage
            2. lamina of cricoid cartilage
            3. cricothyroid membrane (ligament)
        2. Bone
          1. Hyoid bone
            1. Hyo-epiglottic ligament
    3. Jugular notch
    4. Lower Airway Tract
      1. Trachea -- Spatial relationship to esophagus
      2. Carina -- Angle of Louis
      3. Bronchi
      4. Lungs
        1. Bronchioles
          1. bronchial smooth muscle
          2. beta-two adrenergic receptors
        2. Pulmonary cilia
        3. Alveoli -- Surfactant
    5. Support Structures
      1. Chest Cage
        1. Ribs
        2. Muscles of respiration
          1. intercostal muscles
          2. diaphragm
        3. Pleura
          1. parietal pleura
          2. visceral pleura
      2. Phrenic nerve
      3. Mediastinum
  2. Airway Assessment
    1. Purpose
      1. Identify inadequate airway
      2. Identify an unstable airway
      3. Identify potentially difficult airways
    2. Procedure
      1. Gag Reflex
      2. Airway obstruction
        1. Soft tissue obstruction
        2. Foreign bodies
        3. Complete and incomplete
        4. Upper vs. Lower
      3. Work of breathing
      4. Laryngospasm
      5. Laryngeal edema
      6. Penetrating injuries
    3. Anticipating the difficult airway
      1. Trauma/bleeding
      2. Vomiting
      3. History
      4. Mouth opening
      5. Mandibular length
      6. Mallampati classifications
      7. Obstructions
      8. Neck mobility
      9. Facial hair
  3. Techniques of assuring a patent airway
    1. Manual airway maneuvers
    2. Mechanical airway devices
    3. Relief of Foreign Body Airway Obstruction
      1. Refer to current American Heart Association guidelines
      2. Removal of foreign body airway obstructions using direct laryngoscopy
        1. Purpose
        2. Indications
        3. Contraindications
        4. Complications
        5. Procedure
        6. Limitation
      3. Airway suctioning
        1. Review and elebaorate on the upper airway suctioning material from the EMR, EMT and AEMT levels
        2. Tracheobronchial Suctioning
          1. purpose
          2. indications
          3. contraindications
          4. complications
          5. procedure
          6. limitation
    4. Blind insertion airway devices
    5. Endotracheal intubation
      1. Direct laryngoscopy (visualized)
        1. Purpose
        2. Indications
        3. Contraindications
        4. Complications
        5. Procedure (including confirmation techniques)
        6. Limitations
      2. Non-visualized
        1. Nasal
          1. purpose
          2. indications
          3. contraindications
          4. complications
          5. procedure (including confirmation techniques)
          6. limitations
        2. Digital
          1. purpose
          2. indications
          3. contraindications
          4. complications
          5. procedure (including confirmation techniques)
          6. limitations
        3. Lighted stylet
          1. purpose
          2. indications
          3. contraindications
          4. complications
          5. procedure (including confirmation techniques)
          6. limitations
        4. Fiber optic (Shikaini Seeing Optical Stylet (SOS), Glide scope)
          1. purpose
          2. indications
          3. contraindications
          4. complications
          5. procedure (including confirmation techniques)
          6. limitations
    6. Percutaneous cricothyrotomy
      1. Purpose
      2. Indications
      3. Contraindications
      4. Complications
      5. Procedure (including confirmation techniques)
      6. Limitations
  4. Consider age-related variations in pediatric and geriatric patients
    1. See Special Patient Populations section

Content Creator: Josh Renolds

CAPCE Course Number: 21-EMTP-F3-6204

Total CE Hours: 2.0

Level: Advanced

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.