Anaes SAQs · Paediatric anaesthesia
Difficult and syndromic paediatric airway: anticipation, syndromes, and algorithms
Final-examination SAQ for difficult-paediatric-airway-syndromic.
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ANZCAFRCAEDAICABAFCAI
Prompt
A 2-year-old with Pierre Robin sequence needs emergency surgery for incarcerated hernia. Outline airway assessment, induction strategy, equipment, and failed intubation plan.
Model answer
Assessment (3). Micrognathia, glossoptosis, obstruction when supine, prior history (taught Pierre Robin features).[1]
Strategy (6). Senior help, ENT, spontaneous ventilation preference, VL/FOI, SGA ready, position lateral/prone for obstruction.[1]
Failure (6). Limit attempts, re-oxygenate, SGA, age-appropriate CICO/surgical pathway with ENT; airway anomaly carries laryngospasm OR 3.35.[1][2]
References3ShowHide
- [1]Black AE et al. Development of a guideline for the management of the unanticipated difficult airway in pediatric practice. Paediatric Anaesthesia, 2015.PMID 25684039
- [2]Flick RP et al. Risk factors for laryngospasm in children during general anesthesia. Paediatric Anaesthesia, 2008.PMID 18315633
- [3]Shi F et al. Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis. Journal of Anesthesia, 2016.PMID 26296534