One of the most fundamental skills of a pre-hospital EMS provider is management of the airway. Having the knowledge of the anatomy and physiology of the pediatric airway along with the various tools now at our disposal, have allowed the opportunity to have a much more successful rate of securing the pediatric airway. The one thing to remember is, “Kids are not small adults!”
There are many differences from the anatomical and physiological perspective along with pathological conditions that require special attention when providing an airway to the pediatric patient.
Anatomical & Physiological differences
First and foremost, the one of the biggest and more obvious differences between the adult and pediatric airway is the large occipital …show more content…
The large tongue makes it more difficult to visualize the larynx even under direct laryngoscopy. A decreased level of consciousness due to sedation, head injury, metabolic disturbances and other nervous system dysfunctions are some common causes of upper airway obstruction via the tongue.
Another relevant part of the pediatric airway is the epiglottis and the larynx. The epiglottis is large and floppy and the larynx is funnel shaped with the narrowest part of the airway at the cricoid cartilage. The larynx in a pediatric is only about 5-7 centimeters long resulting in right main-stem and accidental extubation. Figure 3
FIGURE 3
Just as there are noted anatomical differences, we can not forget the physiological differences as well. Due to these noted differences, the patient is more susceptible to hypoxemia. Pediatric patients have a lower functional capacity and an increased tidal volume compared to that of the adult …show more content…
Nasopharyngeal airways are good at helping relieve upper airway obstruction during bag mask ventilation. Oropharyngeal airways play a vital role in the management of a patient who is unresponsive with no gag reflex in ensuring the tongue is kept out of the way to ensure proper ventilation and oxygenation to the patient. Another important thing to remember is that pediatric patients most commonly present with a full stomach as they rarely go longer than just a couple of hours without oral intake. This could present a challenge as managing the patient who has vomited and aspirated becomes much more challenging in providing ventilations and ensuring airway compliance. Think of it this way… “Bellies + bag-mask = barfing.” Even with proper positioning and placement of an oral airway, bag mask ventilation will result in air being forced into the stomach causing the patient to vomit and aspirate making the management the pediatric airway much more
There are many differences from the anatomical and physiological perspective along with pathological conditions that require special attention when providing an airway to the pediatric patient.
Anatomical & Physiological differences
First and foremost, the one of the biggest and more obvious differences between the adult and pediatric airway is the large occipital …show more content…
The large tongue makes it more difficult to visualize the larynx even under direct laryngoscopy. A decreased level of consciousness due to sedation, head injury, metabolic disturbances and other nervous system dysfunctions are some common causes of upper airway obstruction via the tongue.
Another relevant part of the pediatric airway is the epiglottis and the larynx. The epiglottis is large and floppy and the larynx is funnel shaped with the narrowest part of the airway at the cricoid cartilage. The larynx in a pediatric is only about 5-7 centimeters long resulting in right main-stem and accidental extubation. Figure 3
FIGURE 3
Just as there are noted anatomical differences, we can not forget the physiological differences as well. Due to these noted differences, the patient is more susceptible to hypoxemia. Pediatric patients have a lower functional capacity and an increased tidal volume compared to that of the adult …show more content…
Nasopharyngeal airways are good at helping relieve upper airway obstruction during bag mask ventilation. Oropharyngeal airways play a vital role in the management of a patient who is unresponsive with no gag reflex in ensuring the tongue is kept out of the way to ensure proper ventilation and oxygenation to the patient. Another important thing to remember is that pediatric patients most commonly present with a full stomach as they rarely go longer than just a couple of hours without oral intake. This could present a challenge as managing the patient who has vomited and aspirated becomes much more challenging in providing ventilations and ensuring airway compliance. Think of it this way… “Bellies + bag-mask = barfing.” Even with proper positioning and placement of an oral airway, bag mask ventilation will result in air being forced into the stomach causing the patient to vomit and aspirate making the management the pediatric airway much more