Pediatric emergency medicine trisk 0180 0180
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The laryngeal tube is designed for blind placement in the esophagus, with a single
port that inflates a dual cuff (one above and one below the opening for airflow)
which secures the device in the hypopharynx and directs airflow anteriorly into
the glottis. Laryngeal tubes are now made in sizes down to size 0, designed for
use in infants less than 5 kg. Laryngeal tubes are increasing being used in the
prehospital setting, therefore PEM clinicians should be familiar with their use,
even if they are placed infrequently in emergency medicine.
Perilaryngeal Airway
The perilaryngeal airway is a device with an inflatable cuff proximal to a widened
distal end, designed to sit posterior to the larynx. Randomized trials in
anesthetized patients (including children) have demonstrated comparable speed
and ease of placement when compared with LMAs. Perilaryngeal airways are also
suitable for bronchoscopy and intubation through the distal end when correctly
placed.
Suggested Readings and Key References
American College of Emergency Physicians. Verification of endotracheal
intubation: Policy statement. Revised January, 2016. Available online at
. Accessed January, 2020.
April MD, Arana A, Pallin DJ, et al. Emergency department intubation success
with succinylcholine versus rocuronium: a National Emergency Airway
Registry study. Ann Emerg Med 2018;72(6):645–653.
Baekgaard JS, Eskesen TG, Sillesen M, et al. Ketamine as a rapid sequence
induction agent in the trauma population: a systematic review. Anesth Analg
2019;128(3):504–510.
Balaban O, Tobias JD. Videolaryngoscopy in neonates, infants, and children.
Pediatr Crit Care Med 2017;18(5):477–485.
Berg K, Gregg V, Cosgrove P, et al. The administration of postintubation sedation
in the pediatric emergency department. Pediatr Emerg Care 2019. doi:
10.1097/PEC.0000000000001744. [published online ahead of print, January
29, 2019]
Brown CA 3rd, Kaji AH, Fantegrossi A, et al. Video laryngoscopy compared to
augmented direct laryngoscopy in adult emergency department tracheal
intubations: a National Emergency Airway Registry (NEAR) study Acad
Emerg Med 2020;27(2):100–108.
Bruder EA, Ball IM, Ridi S, et al. Single induction dose of etomidate versus other
induction agents for endotracheal intubation in critically ill patients. Cochrane
