Paeds Cases · acute-care-resuscitation-and-toxicology
Rapid sequence intubation in children — OSCE
OSCE assessment and procedural-planning station for a child requiring rapid sequence intubation, with a structured oral of preparation, drug choice and complication management.
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Study tools
Target exams
MRCPCH ClinicalRACP DCE
Prompt
You have 9 minutes with a 3-year-old with worsening respiratory failure who needs intubation. Prepare the equipment and drugs, state your tube size and blade, justify your induction agent, and describe how you would manage a desaturation during the attempt.
Station brief (candidate)
- Prepare the airway equipment and state the endotracheal tube size (uncuffed and cuffed) and laryngoscope blade for this child, showing your formula.
- State your induction agent, neuromuscular blocker, and premedication with doses, and justify the induction choice by the child's haemodynamic state.
- Describe how you would confirm tube placement and how you would manage a desaturation during laryngoscopy.
- Outline the post-intubation care, including sedation and monitoring. [1] [3]
References4ShowHide
- [1]Sagarin MJ Rapid sequence intubation for pediatric emergency airway management. Pediatr Emerg Care, 2002.PMID 12488834
- [3]Zelicof-Paul A Controversies in rapid sequence intubation in children. Curr Opin Pediatr, 2005.PMID 15891426
- [5]Fastle RK Pediatric rapid sequence intubation: incidence of reflex bradycardia and effects of pretreatment with atropine. Pediatr Emerg Care, 2004.PMID 15454737
- [6]Kerrey BT Rapid sequence intubation for pediatric emergency patients: higher frequency of failed attempts and adverse effects found by video review. Ann Emerg Med, 2012.PMID 22424653