Pediatric emergency medicine trisk 0198 0198
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FIGURE 9.3 Management sequence for pediatric life support. CNS, central nervous system;
ECG, electrocardiogram; BP, blood pressure; BUN, blood urea nitrogen; Ca++ , calcium.
AIRWAY
Evaluation
Recognition and treatment of airway obstruction and respiratory failure is crucial
as asphyxia is the most common cause of pediatric arrest. Evidence has
demonstrated that prehospital intubation in children does not improve outcomes
over BVM ventilation in areas without prolonged transit time, yet many children
are still intubated in the field. When a child arrives in the ED with an ETT in
place, verify position immediately. For stable patients, continuously measured
end-tidal CO2 (ETCO2 ) is optimal. Chest radiograph confirms placement. In
arrested patients, interpretation of ETCO2 and breath sounds may be unreliable;
confirm tube placement by laryngoscopy in addition to ETCO2 and CXR. All
