Monday, July 18, 2011

Basic difference between adult and kids + intubation

  • Airway is smaller
  • Tongue is larger within oral/pharyngeal cavity
  • Vocal cords have a lower attachment
  • <10yrs Larynx is funnel shapped and Airway is narrowest below vocal cords
    • Intubation:
      • Below 8 Don't Inflate. The anatomy acts like a cuff so that when intubating you may not need a cuff especially in kids less than 8 years old.
      • Endotracheal size formula: (Age(yr)/4) + 4 for example age is 7 years old then (7/4) +4=7
        • Premie use 2.5, Term 3.0, 6mn 3.5, 1 year 4.0
      • Laryngoscope Blade size:  (straight blades for infants/toddlers) 
        • 1 yr=1.5
        • 6mn =1.0
        • Term = 0-1
        • Premie = 0
        • Age 2-10 yr = 2
        • Age 10 yr = 3
      • If no trama then NG tube placed to prevent gastric distention.
      • Assessment for problems: DOPE - Displacement, Obstruction, Pneumothorax, Equipment Failure.
  • >10 yrs Larynx is cylinder shapped and Airway is narrowest at glottic inlet

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