Intubation (peds) - Revision history

Ostermayer at 17:06, 17 January 2026

2026-01-17T17:06:32Z

← Older revision		Revision as of 17:06, 17 January 2026
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	{{~~Peds top~~}} ~~[[intubation]].~~ ''See [[critical care quick reference]] for pre-calculated airway sizes by weight.''		{{PediatricPage\|intubation}} ''See [[critical care quick reference]] for pre-calculated airway sizes by weight.''

	==Airway Adjuncts==		==Airway Adjuncts==

Elcatracho: /* Neonatal Considerations */

2021-01-11T17:38:42Z

Neonatal Considerations

← Older revision		Revision as of 17:38, 11 January 2021
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	***Transitions to C3/4 by age 7 years		***Transitions to C3/4 by age 7 years
	***At C5 by adulthood		***At C5 by adulthood
			**Narrowest portion of airway is at cricoid cartilage (as opposed to vocal cords in adults)
	**Larger/floppier epiglottis		**Larger/floppier epiglottis
	**Short trachea--> easy to mainstem tube, easy for accidental tube dislodgement		**Short trachea--> easy to mainstem tube, easy for accidental tube dislodgement

Elcatracho: /* Neonatal Considerations */

2021-01-11T17:36:59Z

Neonatal Considerations

← Older revision		Revision as of 17:36, 11 January 2021
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	**Large occiput--> may need shoulder roll to get ear to sternal notch aligned		**Large occiput--> may need shoulder roll to get ear to sternal notch aligned
	**Relatively larger tongue, small mouth		**Relatively larger tongue, small mouth
	**More anterior larynx		**More anterior and superior larynx<ref>Nagler J, Mick NW. Airway Management for the Pediatric Patient. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 161.</ref>
			***Glottic opening at level of C1 in infants
			***Transitions to C3/4 by age 7 years
			***At C5 by adulthood
	**Larger/floppier epiglottis		**Larger/floppier epiglottis
	**Short trachea--> easy to mainstem tube, easy for accidental tube dislodgement		**Short trachea--> easy to mainstem tube, easy for accidental tube dislodgement
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	# Numbered list item		# Numbered list item

	==Neonatal Intubation==		==Neonatal Intubation==
	{\| {{table}}		{\| {{table}}

Elcatracho: /* Los Angeles Airway CardAnesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles Airway Card */

2020-11-25T17:40:44Z

Los Angeles Airway CardAnesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles Airway Card

← Older revision		Revision as of 17:40, 25 November 2020
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	**Neonate: Nasal septum to tragus in cm + 1 cm		**Neonate: Nasal septum to tragus in cm + 1 cm

	*Atropine		*[[Atropine\|Atropine]]
	**While atropine is not routinely recommended for pretreatment before RSI, it has been frequently used for infants younger than one year due to their predilection for bradycardia during RSI. However, rare cases of ventricular tachycardia and fibrillation have been seen in pretreatment of children, hence it is not recommended for this age group.<ref>Fleming B, McCollough M; Henderson SO. Myth: Atropine should be administered before succinylcholine for neonatal and pediatric intubation. Can J Emerg Med 2005;7(2):114-7</ref><ref>Tsou CH, Chiang CE, Kao T, et al. Atropine-triggered idiopathic ventricular tachycardia in an asymptomatic pediatric patient. Can J Anaesth 2004; 51:856</ref><ref>Fastle RK, Roback MG. Pediatric rapid sequence intubation: incidence of reflex bradycardia and effects of pretreatment with atropine. Pediatr Emerg Care 2004; 20:651</ref>		**While atropine is not routinely recommended for pretreatment before RSI, it has been frequently used for infants younger than one year due to their predilection for bradycardia during RSI. However, rare cases of ventricular tachycardia and fibrillation have been seen in pretreatment of children, hence it is not recommended for this age group.<ref>Fleming B, McCollough M; Henderson SO. Myth: Atropine should be administered before succinylcholine for neonatal and pediatric intubation. Can J Emerg Med 2005;7(2):114-7</ref><ref>Tsou CH, Chiang CE, Kao T, et al. Atropine-triggered idiopathic ventricular tachycardia in an asymptomatic pediatric patient. Can J Anaesth 2004; 51:856</ref><ref>Fastle RK, Roback MG. Pediatric rapid sequence intubation: incidence of reflex bradycardia and effects of pretreatment with atropine. Pediatr Emerg Care 2004; 20:651</ref>

Hoxbox: /* External Links */

2020-10-17T21:24:21Z

External Links

← Older revision		Revision as of 21:24, 17 October 2020
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	==External Links==		==External Links==
	*Practical pediatric RSI/vent algorithm: http://pemsource.org/wp-content/uploads/2016/11/RSI-and-Ventilator-Settings-Algorithm.pdf		*Practical pediatric RSI/vent algorithm: http://pemsource.org/wp-content/uploads/2016/11/RSI-and-Ventilator-Settings-Algorithm.pdf
			*Adventures in RSI from Pediatric Emergency Playbook (with preferred agents in different patients) http://pemplaybook.org/podcast/adventures-in-rsi/

	==References==		==References==

Rossdonaldson1: /* Drugs */

2020-07-02T17:12:20Z

Drugs

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	**[[Fentanyl]] 1mcg/kg		**[[Fentanyl]] 1mcg/kg
	**[[Etomidate]] 0.3mg/kg		**[[Etomidate]] 0.3mg/kg
	*[[Neuromuscular blocking agents\|Paralytic]]		*[[Neuromuscular blocking agents\|Paralytic]] (Consider doubling dose in shock)
	''Consider doubling dose in shock''
	**[[Rocuronium]] 1.2mg/kg		**[[Rocuronium]] 1.2mg/kg
	***Preferred as may not yet be aware of preexisting conditions that would make sux contraindicated		***Preferred as may not yet be aware of preexisting conditions that would make sux contraindicated

Rossdonaldson1: /* Drugs */

2020-07-02T17:11:51Z

Drugs

← Older revision		Revision as of 17:11, 2 July 2020
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	**[[Fentanyl]] 1mcg/kg		**[[Fentanyl]] 1mcg/kg
	**[[Etomidate]] 0.3mg/kg		**[[Etomidate]] 0.3mg/kg
	*[[Neuromuscular blocking agents\|Paralytic]]~~- consider double~~ dose in shock		*[[Neuromuscular blocking agents\|Paralytic]]
			''Consider doubling dose in shock''
	**[[Rocuronium]] 1.2mg/kg		**[[Rocuronium]] 1.2mg/kg
	***Preferred as may not yet be aware of preexisting conditions that would make sux contraindicated		***Preferred as may not yet be aware of preexisting conditions that would make sux contraindicated
	**[[Succinylcholine]] 1.5mg/kg		**[[Succinylcholine]] 1.5mg/kg


	==See Also==		==See Also==

Rossdonaldson1: /* See Also */

2020-07-02T16:44:17Z

Rossdonaldson1: /* See Also */

2020-06-04T21:07:40Z

Rossdonaldson1: /* See Also */

2020-06-04T21:07:15Z

← Older revision		Revision as of 16:44, 2 July 2020
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	==See Also==		==See Also==
	*[[Critical care ~~quick reference]]~~		{{Pediatric critical care pages}}
	*[[PALS (Main)]]
	*[[Pediatric Vital Signs]]
	*[[Neonatal resuscitation]], [[newborn resuscitation]]

	{{Related Difficult Airway Pages}}		{{Related Difficult Airway Pages}}
	{{Mechanical ventilation pages}}		{{Mechanical ventilation pages}}

← Older revision		Revision as of 21:07, 4 June 2020
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	*[[Pediatric Vital Signs]]		*[[Pediatric Vital Signs]]
	*[[Neonatal resuscitation]], [[newborn resuscitation]]		*[[Neonatal resuscitation]], [[newborn resuscitation]]
	*[[Pediatric jet ventilation]]

	{{Related Difficult Airway Pages}}		{{Related Difficult Airway Pages}}

← Older revision		Revision as of 21:07, 4 June 2020
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	*[[Neonatal resuscitation]], [[newborn resuscitation]]		*[[Neonatal resuscitation]], [[newborn resuscitation]]
	*[[Pediatric jet ventilation]]		*[[Pediatric jet ventilation]]
	*[[The difficult airway]]

	{{Related Difficult Airway Pages}}		{{Related Difficult Airway Pages}}