Unanticipated Difficult Airway in a Neonate: Are we Prepared for this CHAOS?

Karnik, Priyanka Pradeep; Dave, Nandini; Garasia, Madhu

doi:10.5152/tjar.2017.49404

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…If an adequate airway was eventually achieved, this was usually by an ENT surgeon through a tracheostomy. [11][12][13][14] In the out-of-hospital setting, observational studies from national physician-staffed Helicopter Emergency Medical Services reported an approximate incidence of 0.01%-0.05% for eFONA; however, success rates were not elaborated further. 15,16 A systematic review by Morton et al, which included 69 studies with a total of 29 reported prehospital eFONA attempts in children, calculates a pooled success rate of 74% for prehospital eFONA in children, most of them being older than 10 years.…”

Section: Epidemi Ology Of Emerg En C Y Fro Nt-o F-neck Acce Ss: the M...mentioning

confidence: 99%

“…11 Other in-hospital case reports similarly indicate that the skills and knowledge required for successful eFONA in children are insufficient. [12][13][14] In most instances, an initial attempt at cricothyroidotomy was unsuccessful. If an adequate airway was eventually achieved, this was usually by an ENT surgeon through a tracheostomy.…”

Section: Epidemi Ology Of Emerg En C Y Fro Nt-o F-neck Acce Ss: the M...mentioning

confidence: 99%

“…In most instances, an initial attempt at cricothyroidotomy was unsuccessful. If an adequate airway was eventually achieved, this was usually by an ENT surgeon through a tracheostomy 11–14 …”

Section: Epidemiology Of Emergency Front‐of‐neck Access: the Magnitud...mentioning

confidence: 99%

“…Furthermore, the 4th UK National Audit Project reported a high failure rate for needle cricothyroidotomy in adults; in children, the procedure might likely be even more demanding 11 . Other in‐hospital case reports similarly indicate that the skills and knowledge required for successful eFONA in children are insufficient 12–14 . In most instances, an initial attempt at cricothyroidotomy was unsuccessful.…”

Section: Epidemiology Of Emergency Front‐of‐neck Access: the Magnitud...mentioning

confidence: 99%

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Emergency front‐of‐neck access in pediatric anesthesia: A narrative review

Haag,

Tredese,

Bordini

et al. 2024

Pediatric Anesthesia

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Background and ObjectivesChildren undergoing airway management during general anesthesia may experience airway complications resulting in a rare but life‐threatening situation known as “Can't Intubate, Can't Oxygenate”. This situation requires immediate recognition, advanced airway management, and ultimately emergency front‐of‐neck access. The absence of standardized procedures, lack of readily available equipment, inadequate knowledge, and training often lead to failed emergency front‐of‐neck access, resulting in catastrophic outcomes. In this narrative review, we examined the latest evidence on emergency front‐of‐neck access in children.MethodsA comprehensive literature was performed the use of emergency front‐of‐neck access (eFONA) in infants and children.ResultsEighty‐six papers were deemed relevant by abstract. Finally, eight studies regarding the eFONA technique and simulations in animal models were included. For all articles, their primary and secondary outcomes, their specific animal model, the experimental design, the target participants, and the equipment were reported.ConclusionBased on the available evidence, we propose a general approach to the eFONA technique and a guide for implementing local protocols and training. Additionally, we introduce the application of innovative tools such as 3D models, ultrasound, and artificial intelligence, which can improve the precision, safety, and training of this rare but critical procedure.

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Section: Epidemi Ology Of Emerg En C Y Fro Nt-o F-neck Acce Ss: the M...mentioning

confidence: 99%

Section: Epidemi Ology Of Emerg En C Y Fro Nt-o F-neck Acce Ss: the M...mentioning

confidence: 99%

Section: Epidemiology Of Emergency Front‐of‐neck Access: the Magnitud...mentioning

confidence: 99%

Section: Epidemiology Of Emergency Front‐of‐neck Access: the Magnitud...mentioning

confidence: 99%

See 2 more Smart Citations

Emergency front‐of‐neck access in pediatric anesthesia: A narrative review

Haag,

Tredese,

Bordini

et al. 2024

Pediatric Anesthesia

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“…To surmount these difficulties, a special multidisciplinary approach and particular precautions are needed. 3 In this case report, we describe the airway management and precautions taken for the anesthesia of a newborn scheduled for surgical removal of a congenital palate teratoma with a cleft palate. with a cleft lip and palate (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Airway management in a rare case of congenital palate teratoma with a cleft palate: A case report

Regaieg,

Jarraya,

Ammar

et al. 2023

SAGE Open Medical Case Reports

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Airway management in neonates is difficult because of the risk of rapid hypoxia. It presents a challenge even for an experienced anesthesiologist. Oral tumors in neonates can obstruct the airway or feeding problems in the newborn. Surgical excision is the treatment of choice but these tumors can seriously worsen the conditions of intubation. To surmount these difficulties, a particular multidisciplinary approach and special precautions are needed. We describe the airway management and precautions taken in the anesthesia for surgical removal of a case of large congenital palate teratoma associated with a wide cleft palate in a 25-day-old girl. Impossible intubation was predicted on magnetic resonance imaging. The difficult airway management cart as well as an otorhinolaryngologist skilled in performing emergency tracheostomies in neonates were available. The patient was intubated by conventional laryngoscopy under sevoflurane inhalation anesthesia. The tumor was successfully resected. This case poses a challenge for managing the airway because of the possibility of obstruction of the airway and the difficulty of the airway that radiological exams have allowed us. So, a multidisciplinary team effort is needed for successful neonatal airway management.

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