Emergency rescue devices for difficult pediatric airway management
- Brent R King, MD, MMM
Brent R King, MD, MMM
- Professor of Pediatrics and Emergency Medicine
- The Sidney Kimmel Medical College at Thomas Jefferson University
- Chief Medical Officer and Physician-in-Chief
- Nemours Alfred I DuPont Hospital for Children
- Section Editor
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
In patients with difficult airways, rescue devices (eg, laryngeal mask airway) allow for oxygenation and ventilation until a definitive airway can be secured. Emergency rescue devices may be lifesaving in children with difficult airways in whom conventional endotracheal intubation has failed. They should be available for any child undergoing emergent endotracheal intubation. This topic discusses the indications, contraindications, and techniques for use of such devices in children.
The following pediatric topics on the difficult airway are presented elsewhere:
●Identification of the difficult airway (see "The difficult pediatric airway")
●Devices to facilitate endotracheal intubation (see "Devices for difficult endotracheal intubation in children")
●Needle cricothyroidotomy (see "Needle cricothyroidotomy with percutaneous transtracheal ventilation")
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- CONTINGENCY PLAN FOR THE FAILED AIRWAY
- CHOICE OF DEVICE
- LARYNGEAL MASK AIRWAY (LMA)
- Choice of technique
- - Rotational technique
- - Standard technique
- Intubating laryngeal mask airway (ILMA)
- - Indications
- - Contraindications
- - Technique
- - Pitfalls
- Air-Q masked laryngeal airway
- - Technique: Insertion of the air-Q
- - Technique: Intubation using the air-Q
- - Removal of the air-Q
- - Pitfalls
- i-gel LARYNGEAL AIRWAY
- Standard technique
- Rotational technique
- Indications and contraindications
- LARYNGOTRACHEAL AIRWAYS
- Indications and contraindications
- - Blind technique
- - Alternative technique
- SUMMARY AND RECOMMENDATIONS