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Acute Esophageal Variceal Bleeding in Children

Pediatric EM Morsels

Multimodal management can help avoid variceal bleeding. Luoto, 2020 ] Acute Esophageal Variceal Bleeding: Management Guidelines on the management of acute variceal bleeding in children are limited and debated due to limited pediatric-specific evidence. Prepare airway management tools (hoping to avoid needing them).

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Glasgow Coma Scale in Children

Pediatric EM Morsels

[Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients. Consider other indicators of need for airway management, such as gag reflex.

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REBEL Core Cast 108.0 – Angioedema

RebelEM

Take Home Points: Airway management is paramount; expect a challenging intubation and consider controlling the airway early if there is apparent airway compromise. Understanding the cause of angioedema (mast cell vs. bradykinin mediated) helps dictate directed management.

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Supraglottic Airways

Pediatric Emergency Playbook

How much force is required to dislodge an alternate airway? An update on out-of-hospital airway management practices in the United States. Successful tracheal intubation through an intubating laryngeal airway in pediatric patients with airway hemorrhage. 2011 Oct;41(4):369-73. 2011 Dec;66 Suppl 2:45-56.

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Episode 19: Surgical Airway

PHEM Cast

Other fantastic #FOAM resources regarding airway management are available: From Nicholas Chrimes at [link] From the fabulous people over at Life in the Fast Lane including a video demo from Scott Weingart from EMCrit: [link] References This is Tim’s recent publication we mention in the ‘cast! Woodall, N., & Frerk, C.

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Intubation

PHEM Cast

Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K. 2011 Dec;82(12):1519-24. Epub 2011 Jul 2. Guidance documents College of Paramedics Statement on Intubation, available here. Tracheal intubation. 20(12);681-686.

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Episode 36: COVID-19

PHEM Cast

if resuscitation is to be continued, take over patient management from any responder wearing level 2 PPE all responders wearing level 2 PPE are to leave the scene (more than 2m away from the patient) prior to the commencement of any airway management, ventilation or other AGPs. 2011; 6(11): e27932. Rutala (a2), David J.

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