Presentation is loading. Please wait.

Presentation is loading. Please wait.

Company Name Airway Management in Children Eddy Cousinery - RCH.

Similar presentations


Presentation on theme: "Company Name Airway Management in Children Eddy Cousinery - RCH."— Presentation transcript:

1 Company Name Airway Management in Children Eddy Cousinery - RCH

2 1.Paediatric Anatomy 2.How to assess an airway 3.How to prepare for a predicted difficult airway 4.How to manage the “easy airway” in trouble OVERVIEW

3 Paediatric Anatomy Airway  Head Larger (occiput)  TongueRelatively large  LarynxHigher(C2-C3) & appears anterior  EpiglottisLarger/U Shaped

4 How to assess an airway? Use the Mallampati classification to identify degree of difficulty or ease of the airway Class 2 - Arytenoids cartilages and posterior part of vocal chords visible Class 1 - - Visualisation of the vocal chords Class 3 - Epiglottis visible Class 4 - Epiglottis not visible

5 How to assess an airway? (Almost) all difficult airways in children can be predicted by:  History Well with a normal voice? No OSA? Do they have a condition associated with difficult airway ?  Examination –Stridor/abnormal voice (eg. Laryngeal papilloma/ burn –Dysmorphic features

6 Treacher-Collins Difficult airway Prediction

7 Mucopolysaccharidoses Hunter/Hurler Syndrome

8 How to prepare for a predicted difficult airway Conditions associated with difficult airway Arthrogryphosis

9 How to prepare for a predicted difficult airway  Good assessment  Strategic planning, communication and preparation  Suitable staff who are trained  Suitable equipment  Stay calm

10 What Equipment??

11 What Equipment? Depends on plan, but:  SIMPLE equipment should not be forgotten (Eg. Co 2 monitoring) in favour of the expensive and complicated.  BOUGIES=VITAL  Advanced Fibre-optic – ready to use and planned how to use

12 Easy airway in trouble management  Any airway can turn into a compromised airway  Most common in children is Laryngospasm.

13 Scenario An airway develops acute obstruction after extubation, what approach do we take?

14  100% oxygen, mask, call for help  Open airway manoeuvres, T-piece  Positive pressure to airway by mask (CPAP) Immediate management

15 Laryngospasm Management  How to proceed? Partial Complete

16 Secure Taping Formula to calculate tube size ETT: 3.5kg 3.5mm ETT: size mm = 4 + age/4: length (cm) at lip = 12 + age/2 at nose = 15 + age/2

17 SUMMARY  Almost all difficult airways in children can be predicted by the presence of dysmorphism or the history of a condition which is associated with a difficult airway.  Careful Assessment, Strategic planning, communication, correct personnel and equipment are the keys to success.

18 SUMMARY A recent UK audit demonstrated airway disasters are rare but occur with devastating effects. The causes were often related to:  Poor judgement (inadequate assessment, poor strategic planning, persisting in trying techniques that have already failed).  Lack of Education and training was also identified as a cause.

19 Acknowledgement My sincere thanks for their help in developing this presentation :  Dr Adam Skinner  Dr Phil Ragg  Dr Nick Martin References: Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia" Cook TM, Woodall N, Ferk C. Br J Anaesth 2011; 106: 617-631 Proposal for the management of the unexpected difficult pediatric airway, Markus Weiss & Thomas Engelhardt – Pediatric Anaesthesia 2010; 20 454-464


Download ppt "Company Name Airway Management in Children Eddy Cousinery - RCH."

Similar presentations


Ads by Google