Pediatric intubation

[Spock]

I'm going to come down on the side of removing pediatric intubations because it is easy to bag a kid but not necessarily easy to intubate. PALS recommends that intubation be left to only the most experienced and promotes BVM ventilation. As mentioned if you can ventilate the kid you can most likely avoid the cardiac arrest. The comment about the saturation staying in the 90's for a few minutes of apnea only applies to a healthy patient.

Plus there are very few alternative airways for kids. LMA's do come in pediatric sizes all the way down to the neonate but the King has no sizes for under three feet and the combitube has no pediatric sizes. Most paramedics so not have the LMA available to them. My service MIGHT see one pediatric intubation in a year. Hardly enough to maintain proficiency. I work in an adult trauma center and do maybe 6 pediatric intubations in a year (mostly burns.) Is that enough for me to maintain proficiency? I don't know.

Live long and prosper.

Spock

[Doczilla]

The push away from pediatric intubation comes from a couple of recent studies showing that, controlling for injury severity and other factors, kids who are intubated in the prehospital setting have worse outcomes that kids who aren't. Before you say "it's a skill or practice thing", I don't think we've locked in on exactly why.

'zilla