Alternative Airway Devices for Use in Children Requiring Prehospital Airway Management

Youngquist, Scott T.; Gausche‐Hill, Marianne; Burbulys, David B.

doi:10.1097/pec.0b013e31803f7552

Cited by 18 publications

(10 citation statements)

References 130 publications

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“…24 Also, there is increasing awareness of the possible role of supraglottic airway devices, such as the LMA TM , in children requiring pre-hospital airway management. 25 Furthermore, studies using simulation technology appear to show an advantage of the LMA TM over tracheal intubation during simulated pediatric cardiac arrest managed by paramedics. 26 In addition, a study of apneic anesthetized children showed that the LMA TM compared favourably with a facemask when used by critical care nurses as a means to ventilate the lungs.…”

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confidence: 99%

“…24 En outre, on s'intéresse de plus en plus au rôle potentiel des dispositifs supraglottiques tels que le LMA TM chez les enfants nécessitant une prise en charge des voies aériennes avant leur arrivée à l'hôpital. 25 Qui plus est, des études utilisant des techniques de simulation semblent montrer un avantage du LMA TM par rapport à l'intubation trachéale pendant un arrêt cardiaque pédiatrique simulé pris en charge par des ambulanciers. 26 De plus, une étude portant sur des enfants anesthésiés et en apnée a montré que le LMA TM soutenait la comparaison avec un masque facial lorsqu'il était utilisé par des infirmières des soins intensifs afin de ventiler les poumons.…”

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Supraglottic airways in children: past lessons, future directions

Cox

Lardner

2009

Can J Anesth/J Can Anesth

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The first prototype of the laryngeal mask airway (LMA TM ) was used clinically in the summer of 1981 at Ashford, Kent, UK, by Dr. Archie Brain. Dr. Brain followed in the worthy footsteps of Clover, O'Dwyer, Shipway, Leech, and others in developing a supraglottic airway to facilitate the delivery of anesthetic gases via a reliable supraglottic airway. 1 The LMA TM was released in the UK in 1988 and in the USA in 1992. Since the original range of pediatric LMAs TM was soon found to be inadequate to address all children's sizes, half-sizes (1.5 and 2.5) were developed. As with adult practice, the LMA TM and other supraglottic airways have radically changed pediatric anesthesia practice and have become a key component of airway management in children, both in the operating room and in remote anesthesia locations. These devices have increasingly been advocated for emergency airway control in the field, in the emergency department, and in the delivery suite. So what have we learned about pediatric supraglottic airways over the past two decades and where does the future lie with respect to these devices?Much of the published research in this area relates to the LMA Classic TM . From the clinical anesthesiologist's perspective, the following questions relating to the LMA Classic TM are important: When should it be used (patient and procedure related factors), how should it be used, and when should an alternative device be used?Indications for the use of the LMA Classic TM are extensive, and it is often the airway of choice in routine general anesthesia for minor procedures in children. In a prospective study of 1,400 children who had LMA TM -based anesthesia conducted by supervised trainees, the device was found to be highly effective for a broad range of surgical procedures, and there was no instance where the LMA TM had to be replaced with an endotracheal tube (ETT). 2 Initial misgivings about the use of the LMA TM for head and neck procedures were shown to be largely unfounded. For example, the LMA TM was shown to be safe and effective when used for ophthalmological surgery and adenotonsillectomy in children 3,4 ; however, these situations require a surgeon with some insight that the trachea is not intubated.Pediatric anesthesia is increasingly being delivered in areas outside the operating room where the LMA TM has been proven to be particularly valuable. For instance, the LMA TM has been used for radiotherapy, 5 magnetic resonance imaging, 6 fibreoptic bronchoscopy, 7 and upper gastrointestinal endoscopy. 8 Its relative stability combined with the ease of respiratory monitoring and the relative lack of airway complications are distinct advantages in these remote locations.One clinical scenario of particular interest is the difficult pediatric airway. Here the LMA TM has proven to be invaluable both as a rescue airway device in the child with a difficult airway and as a conduit for fibreoptic bronchoscopy and endotracheal intubation. 7 Consequently, the LMA TM has a role in both anticipated and unanticipated difficu...

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confidence: 99%

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Supraglottic airways in children: past lessons, future directions

Cox

Lardner

2009

Can J Anesth/J Can Anesth

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“…3,5,6 In both simulation and field studies, the adult King LT-D has been more rapidly deployed with fewer attempts than both ETI and the Combitube. [7][8][9] The adult King LT-D airway has also been used successfully as part of a rapid-sequence intubation (RSI) protocol.…”

Section: Introductionmentioning

confidence: 98%

“…Additionally, pediatric surgical cricothyrotomy in the field is generally not feasible because of difficulty identifying landmarks and the greater potential for serious complications. 3,4 Prehospital providers treating pediatric patients have been left without a safety net in the "can't intubate, can't ventilate" situations and without a means of securing an airway if intubation fails but ventilation is still possible.…”

Section: Introductionmentioning

confidence: 99%

Prehospital Pediatric King LT-D Use: A Pilot Study

Ritter

Guyette²

2011

Prehospital Emergency Care

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“…A simple device such as a Guedel airway may be helpful in maintaining airway patency and, for those with the necessary experience, a laryngeal mask is often superior. However, neither device will be tolerated by the child with intact pharyngeal reflexes in whom their use may precipitate vomiting and aspiration [11]. Opening the airway and delivering supplementary oxygen may be all that is required in some circumstances such as airway obstruction due to sedative overdose.…”

Section: Early Intervention In Respiratory Failure and Shockmentioning

confidence: 99%

A practical approach to paediatric emergencies in the radiology department

Turner

2008

Pediatr Radiol

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Acute life-threatening events involving children in the radiology department are rare. Nonetheless, radiologists should be competent in the relatively simple procedures required to maintain or restore vital functions in paediatric patients, particularly if their practice involves seriously ill or sedated children. This article gives a practical overview of the immediate management of paediatric emergencies that the radiologist is likely to encounter, using a structured (ABCD) approach. Emphasis is given to the early recognition of respiratory embarrassment and shock, and early intervention to prevent deterioration towards circulatory arrest. The management of cardiorespiratory arrest, anaphylaxis and convulsions in children is also addressed.

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Alternative Airway Devices for Use in Children Requiring Prehospital Airway Management

Cited by 18 publications

References 130 publications

Supraglottic airways in children: past lessons, future directions

Supraglottic airways in children: past lessons, future directions

Prehospital Pediatric King LT-D Use: A Pilot Study

A practical approach to paediatric emergencies in the radiology department

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