161. Peds airway

Question 1

Cuffed ETT by age formula

Answer 1

(Age/4) + 3.5

Question 2

Uncuffed ETT by age formula

Answer 2

(Age/4) +4

Question 3

Length of tube insertion

Answer 3

Breslow tape

3 x uncuffed tube size

Question 4

7 peds airway differences

Answer 4

1. large occiupt and head
2. large tongue
3. high, anterior airway
4. narrow subglottic region
5. large tonsils and adenoids
6. small crich membrane
7. large stomach and weak sphyncter

Question 5

2 physiological differences

Answer 5

1. high metabolic rate

2. low residual capacity

Question 6

2 pretreatment meds and when to use

Answer 6

1. lidocaine
   - possible before laryngoscopy
2. atropine (0.02mg/kg)
   - maybe < 1yo
   - for pre-existing brady

Question 7

3 induction agents and doses with SE

Answer 7

1. etomidate (0.3mg/kg)
   - adrenal suppression
2. ketamine (1-2mg/kg)
   - vomiting
   - emergence
   - leryngospasm
3. prop (1-2mg/kg)
   - hypoT
   - apena

Question 8

2 paralytics and doses

Answer 8

1. roc (1-1.2mg/kg)

2. succ (2)

Question 9

2 keys to good BMV

Answer 9

1. patent arway

2. good mask seal

Question 10

Steps to intubation (Ps)

Answer 10

Prep
- have everything prepared
Preoxygenation
- desat much faster
- non-rebreather
Positioning
- needs to be age appropriate
Place tube
- straight blade
- use stylet for anterior airways
Post intubation care
- confirm placement
- CXR
- sedatives

Question 11

Options for post intubation sedatives (6)

Answer 11

1. Loraz
2. Midaz
3. Fentanyl
4. Morphine
5. Ketamine
6. Prop

Question 12

Airway rescue devices

Answer 12

1. supraglottic devices
2. esophageal blockers
   - combitube

Question 13

Steps to place needle cric

Answer 13

1. 14G needle cath in membrane

2. place on 1L/min per year age