Airway Management in the Pediatric Trauma Patient

The most immediate concern in the management of any pediatric emergency, including trauma, is airway assessment with assisted or controlled ventilation as needed. In the trauma setting, several factors may increase the risks associated with airway management including cardiorespiratory instability, associated maxillofacial injuries, cervical spine injuries, and the risk of acid aspiration. The author reviews the techniques used to manage the airway in the pediatric trauma patient including the evaluation of the cemcal spine and techniques to protect the cenical spine during endotracheal intubation. Airway management techniques including standard oral endotracheal intubation with sedation and neuromuscular blockade, the approach to the recognized difficult airway, and the techniques used in the “cannot intubate/cannot ventilation” scenario are discussed.