Anaes Vivas · Airway management
The difficult paediatric airway — a clinical scenario viva
A clinical viva on the unanticipated difficult paediatric airway, testing recognition of rapid desaturation, the supraglottic-airway rescue, the role of videolaryngoscopy, the difficult-airway algorithm, and the threshold for front-of-neck access.
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Prompt
A three-year-old, fifteen-kilogram child with a recent upper respiratory tract infection presents for myringotomy. After a gas induction the laryngoscopist obtains a poor view on the first attempt and the saturation falls rapidly from ninety-nine percent into the low eighties within forty seconds of apnoea. Describe your immediate and subsequent management.
Stimulus
A three-year-old, fifteen-kilogram child with a recent upper respiratory tract infection presents for myringotomy. After a gas induction the laryngoscopist obtains a poor view on the first attempt and the saturation falls rapidly from ninety-nine percent into the low eighties within forty seconds of apnoea. Describe your immediate and subsequent management[2][4].
References5ShowHide
- [1]Motykiewicz RA, et al. Enhancing Safety in Pediatric Airway Management: An Integrative Review for Perioperative Nurses. J Perianesth Nurs, 2026.PMID 42319317
- [2]Komasawa N, et al. A proposal for pediatric specific difficult airway management guideline. J Clin Anesth, 2020.PMID 31951919
- [3]Berisha G, et al. Management of the Unexpected Difficult Airway in Neonatal Resuscitation. Front Pediatr, 2021.PMID 34778121
- [4]Garcia-Marcinkiewicz AG, et al. The future of pediatric airway management. Curr Opin Anaesthesiol, 2026.PMID 42013372
- [5]Sasu PB, et al. Diagnostic value of the percentage of glottic opening score for classifying videolaryngoscopy in children: a prospective validation study. Anaesthesia, 2026.PMID 42145174