1. The Pediatric Airway, Respiratory Distress and Failure, & Hypoperfusion Emergencies STEVE MARCHBANK, MD www.pedsteve.com [email_address]

4. Arrest, Continued

9. Upper Airway Obstruction

11. Anatomy Narrowest Point = Cricoid Cartilage Adult Child

17. Lower Airway Obstruction

19. Effect of Edema and Swelling

40. Airway Maneuvers Head Tilt-Chin Lift Jaw Thrust

46. So, what’s in the toolbox?

52. Proper Mask Placement

53. Bag-Mask Ventilation Sellick Maneuver Pressing down on Cricoid cartilage, which compresses the esophagus against the cervical spine

55. ET Tube Children >2 Years: ETT Size: (Age+16) / 4 ETT Depth (lip): ETT size x 3 Size of the tip of pinkie = ETT size

56. Laryngoscope Blades Better in infants/toddlers/younger children with a floppy epiglottis Straight Blade

57. Curved Blade Better in older children (teens/adults) with stiff epiglottis

58. Intubation: Anatomy

81. Mild, Moderate & Severe Shock Mild Shock Mild hemorrhage, compensated shock, mild hypovolemia (<30% blood volume loss) Moderate Shock Moderate hemorrhage, Decompensated Shock, Marked Hypovolemia (30-45% blood volume loss) Severe Shock Severe hemorrhage, cardiopulmonary failure, severe hypovolemia (>45% blood volume loss) Cardiovascular Mild tachycardia Moderate tachycardia Severe tachycardia Weak peripheral pulses Thready peripheral pulses Absent peripheral pulses Strong central pulses Weak central pulses Thready central pulses Low or normal BP Hypotension Profound Hypotension Mild acidosis Moderate acidosis Severe acidosis Respiratory Mild tachypnea Moderate tachypnea Severe tachypnea Neurologic Irritable, confused Agitated, lethargic Obtunded, comatose Skin Cool extremities, mottling Cool extremities, pallor Cold extremities, cyanosis Renal Mild oliguria, ↑ spec grav Marked oliguria, ↑ BUN Anuria

96. The End Remember… a lot of this is straightforward, repeatable, and is medical ‘common sense’, but…. Don’t be afraid to ask questions or ask for help! Steve Marchbank, MD [email_address] www.pedsteve.com