Pediatric airway management

Study Type & Method: Narrative Review

Commentary: This article presents an excellent overview of the current research pertaining to paediatric airway management with a focus on safety improvement. The authors review the current research on airway complications in children from observational studies (2109-2012). This is put into context with a discussion of the anatomy and physiology of the paediatric airway as well as pathology that presents with the difficult airway.

To improve safety for the normal infant airway, the authors suggest that video laryngoscopy may improve the success rate of the first attempt at intubation. For infants with difficult airways, standard blade video laryngoscopy is associated with higher first attempt success rates compared with non-standard blade video laryngoscopy.

In order to reduce the rates of paediatric mortality and morbidity associated with airway management, the authors suggest the implementation of a department “Difficult Airway Clinical Lead” whose role is to “disseminate knowledge, lead quality improvement initiatives, and collaborate with other specialties in their hospital to improve the standard of care for airway management”.

In conclusion, the authors present a paediatric-specific, universal airway management framework with the goal of enhancing the safety of paediatric airway management.

Reviewed by Dr Renee Burton