2015 Trumbull Memorial Hospital Demo

Pediatric Intubation Guidelines

Pediatric Intubation Guidelines

These are general guidelines for all EMS personnel to assist in the decision making process when dealing with a critically ill or injured child. There are no absolute rules that mandate if any given child requires definitive airway versus conservative assistance such as oral airway with BVM. There are many factors that determine the need for definitive airway and all have to be considered. Nature of the situation: Is there a corrective action that may quickly improve the condition (glucose for hypoglycemia, naloxone for narcotic overdose, aerosols for severe bronchospasm) or is the condition going to worsen over time (head trauma, hemorrhagic shock, airway edema / obstruction). Skill level of the available providers: If the available medics are unsure of their pediatric intubation skills and the child is oxygenating well, with adequate airway protection, there should not be an imminent urgency to attempt intubation. Oxygenation and patent airway are the most important issues in determining the need for pediatric intubation. Hypercarbia (high CO2) and Glasgow Coma Scale are determinants used in the hospital but these should not be extrapolated to the field. If a child has a patent airway and is oxygenating well, intubation is not mandatory.

If intubation of a child is needed remember the following:

1. Use a cuffed tube whenever possible but in children under 8 only inflate if needed to oxygenate / ventilate due to air leak

2. Tube size = Age + 16 4 Length = 12 + age/2

178

EMR

EMT

AEMT

Paramedic

Extended