Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.
Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.
Objectives
- The participant will be able to compile a complete list of equipment necessary to perform a pediatric intubation, with acknowledgment of mnemonic.
- The participant will be able to determine the appropriate size and depth of insertion of endotracheal tube based on patient’s age utilizing a common estimation formulas.
- The participant will be able to describe the appropriate patient set up; including positioning for a successful intubation.
When a checklist is elusive a simple mnemonic can be helpful to recall the necessary equipment:
Mnemonic: SOAP ME
Suction Device: Ensure suction is turned on and at appropriate level
- Yaunker or large bore suction tube 14 French
- Consider second suction set up especially if concerned about pulmonary hemorrhage or pulmonary edema
Oxygen Delivery system: ensure oxygen sources is connected and functioning appropriately
- Nasal Cannula vs. High Flow/ Non-Rebreather
- Consider non-Invasive if poor oxygenation
- Consider need for apneic oxygenation depending on clinical situation
- Self-inflating anesthesia bag with appropriately sized mask
Airway Equipment:
- Direct Laryngoscope: Blade type and size considerations
- Video Laryngoscope: CMAC or Glidescope dependent upon access and comfort
- Endotracheal tube: Correct size + size down
- Back up airway IE: Laryngeal Mask Airway (LMA)
Patient Position: Most of procedural success is based upon the appropriate patient positioning
Medication plan: specific to patient and clinical scenario, there are many combinations that can be utilized and some for specific scenarios.
Equipment: ensure all monitors placed appropriately (BP cuff and pulse ox on separate extremities)
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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
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