Airway devices in paediatric anaesthesia

Abstract

Airway devices were first used in children since 1940 and thereafter an increasingly large number of paediatric airway devices have come into our armamentarium. To control and protect the airway in children during anaesthesia, in intensive care unit or in emergency department either tracheal intubation is performed under direct or indirect visualization of vocal cords with the help of laryngoscopes or video-laryngoscopes respectively or it can be done blindly or by using special instruments such as fiberoptic laryngoscope, lighted stylet or Bullard laryngoscope to name a few. Airway also can be maintained with the help of Laryngeal mask airways, oropharyngeal and nasopharyngeal airways. Updating our information and knowledge regarding these developments is pivotal to our practice of paediatric anaesthesia. With a thorough search of books, MEDLINE, MEDNET, clinical trials.gov.in, this article aims at focusing and understanding a brief basis of paediatric devices and their use.

Use of video laryngoscope in a difficult paediatric cleft palate airway: Rescue or primary airway device?

“…VL in comparison to a conventional laryngoscope provides a better view by improving the angulation. [ 4 ] The usefulness and efficiency of airway assistants also increases with VL as glottic visualisation is accessible to everyone rather than just the primary intubator. Considering the sensitive nature of paediatric airway mucosa,[ 5 ] and potential to dynamically worsen with each subsequent conventional attempt, VL should perhaps be used as the first line approach in such anticipated difficult airways.…”

Frova saved the day!!

“…Another option would have been the use of High Flow Humidified Nasal Oxygenation after removal of ETT during airway assessment as well as tracheostomy. There are reports of use of Frova as an intubation aid in paediatrics;[ 5 ] however, we did not find any literature on the use of Frova as a means of oxygenation during airway procedures in children. The use of intubating aids is also fraught with complications such as airway trauma, bleeding, avulsions particularly if not introduced under vision.…”

Design and Development of a Low-Cost Pediatric Videolaryngoscope

“…Because of this, airway management is a critical skill, not only in the surgical context but in any situation where ventilatory support is required in patients whose condition does not allow them to maintain appropriate oxygenation to meet physiological (Fiadjoe et al, 2016). The technique to perform intubation requires a device known as a laryngoscope, in use since 1940 (Swaika et al, 2019). The procedure consists of inserting the laryngoscope through the right side of the oral cavity up to the glossoepiglottic groove, moving the tongue to the left, pulling the device upwards until the vocal cords are visualized, and inserting the endotracheal tube, always visualizing its successful passage through the cords (Ramón and Juan Pablo, 2011).…”