All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The All India Difficult Airway Association guidelines for the management of the unanticipated difficult tracheal intubation in paediatrics are developed to provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in children between 1 and 12 years of age. The incidence of unanticipated difficult airway in normal children is relatively rare. The recommendations for the management of difficult airway in children are mostly derived from extrapolation of adult data because of non-availability of proven evidence on the management of difficult airway in children. Children have a narrow margin of safety and mismanagement of the difficult airway can lead to disastrous consequences. In our country, a systematic approach to airway management in children is lacking, thus having a guideline would be beneficial. This is a sincere effort to protocolise airway management in children, using the best available evidence and consensus opinion put together to make airway management for children as safe as possible in our country.

Related collections

Most cited references 28

Record: found
Abstract: found
Article: not found

Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period.

I Murat, Hélène Maud'huy, Isabelle Constant (2004)

This study reports the practices and morbidity of 24,165 anaesthetics performed over a 30-month period in a paediatric teaching hospital. Data describing practices and adverse events during anaesthesia and in the postanaesthesia care unit (PACU) were collected prospectively from 1 January 2000 to 30 June 2002 on an audit form as a part of the Quality Assurance Program. All surgical specialties are covered except for open heart surgery and neurosurgery. A total of 724 adverse events were reported during anaesthesia and 1105 in PACU. Respiratory events represented 53% of all intraoperative events. They were more frequent in infants compared with older children, in ENT surgery compared with other surgery, in children in whom the trachea was intubated and in children with ASA status 3-5 compared with those with ASA score 1 or 2. Cardiac events accounted for 12.5% of intraoperative events and were mainly observed in children with ASA score 3-5. In PACU, vomiting was the most frequent adverse event with an overall incidence of 6%. Vomiting was more frequent in older children compared with infants and young children and more frequent after ENT surgery compared with other surgery. Only one death was reported in a premature newborn infant and was not anaesthesia-related. This observational study confirms previous reports, and indicates that there is still a relative higher rate of adverse events in infants compared with older children even in a teaching paediatric hospital with a high annual caseload.

0 comments Cited 76 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Pediatric airway management

Jeff Harless, Ramesh Ramaiah, Sanjay Bhananker (2014)

Securing an airway is a vital task for the anesthesiologist. The pediatric patients have significant anatomical and physiological differences compared with adults, which impact on the techniques and tools that the anesthesiologist might choose to provide safe and effective control of the airway. Furthermore, there are a number of pathological processes, typically seen in the pediatric population, which present unique anatomical or functional difficulties in airway management. The presence of one of these syndromes or conditions can predict a “difficult airway.” Many instruments and devices are currently available which have been designed to aid in airway management. Some of these have been adapted from adult designs, but in many cases require alterations in technique to account for the anatomical and physiological differences of the pediatric patient. This review focuses on assessment and management of pediatric airway and highlights the unique challenges encountered in children.

0 comments Cited 41 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

A Irouschek, Torsten Birkholz, Sebastian Heinrich … (2012)

Difficult laryngoscopy in pediatric patients undergoing anesthesia. This retrospective analysis was conducted to investigate incidence and predictors of difficult laryngoscopy in a large cohort of pediatric patients receiving general anesthesia with endotracheal intubation. Young age and craniofacial dysmorphy are predictors for the difficult pediatric airway and difficult laryngoscopy. For difficult laryngoscopy, other general predictors are not yet described. Retrospectively, from a 5-year period, data from 11.219 general anesthesia procedures in pediatric patients with endotracheal intubation using age-adapted Macintosh blades in a single center (university hospital) were analyzed statistically. The overall incidence of difficult laryngoscopy [Cormack and Lehane (CML) grade III and IV] was 1.35%. In patients younger than 1 year, the incidence of CML III or IV was significantly higher than in the older patients (4.7% vs 0.7%). ASA Physical Status III and IV, a higher Mallampati Score (III and IV) and a low BMI were all associated (P < 0.05) with difficult laryngoscopy. Patients undergoing oromaxillofacial surgery and cardiac surgery showed a significantly higher rate of CML III/IV findings. The general incidence of difficult laryngoscopy in pediatric anesthesia is lower than in adults. Our results show that the risk of difficult laryngoscopy is much higher in patients below 1 year of age, in underweight patients and in ASA III and IV patients. The underlying disease might also contribute to the risk. If the Mallampati score could be obtained, prediction of difficult laryngoscopy seems to be reliable. Our data support the existing recommendations for a specialized anesthesiological team to provide safe anesthesia for infants and neonates. © 2012 Blackwell Publishing Ltd.

0 comments Cited 39 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Indian J Anaesth

Journal ID (iso-abbrev): Indian J Anaesth

Journal ID (publisher-id): IJA

Title: Indian Journal of Anaesthesia

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0019-5049

ISSN (Electronic): 0976-2817

Publication date (Print): December 2016

Volume: 60

Issue: 12

Pages: 906-914

Affiliations

[1]Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India

[1 ]Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India

[2 ]Department of Anaesthesiology and Critical Care, K. S. Hegde Medical Academy, Nitte University, Mangalore, India

[3 ]Chief Consultant Anaesthesiologist, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, India

[4 ]Consultant Anaesthesiologist, Kailash Cancer Hospital and Research Centre, Vadodara, Gujarat, India

[5 ]Consultant Anaesthesiologist, Vadodara Institute of Neurological Sciences, Vadodara, Gujarat, India

[6 ]Department of Onco-Anaesthesiology and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India

[7 ]Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India

[8 ]Department of Anaesthesiology and Critical Care, J N Medical College and Hospital, AMU, Aligarh, Uttar Pradesh, India

[9 ]Department of Anaesthesiology, North Bengal Medical College, Darjeeling, West Bengal, India

[10 ]Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India

Author notes

Address for correspondence: Dr. Jeson Rajan Doctor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai - 400 012, Maharashtra, India. E-mail: jesonrdoctor@ 123456gmail.com

Article

Publisher ID: IJA-60-906

DOI: 10.4103/0019-5049.195483

PMC ID: 5168893

PubMed ID: 28003692

SO-VID: 7ba6d41d-c3a8-4702-919e-c30205d0cdc3

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics

Read this article at

Abstract

Related collections

Irish Journal of Paramedicine

Most cited references 28

Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period.

Pediatric airway management

Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 403

Cited by 26

Most referenced authors 175