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Emergency management of the paediatric airway requires an understanding of the anatomic, physiologic, and behavioral differences in infants and children. It also requires specific skills that EMS providers do not have many opportunities to practice. A comprehensive, easily understandable text, Paediatric Airway Management for the Prehospital Professional teaches EMS providers how the paediatric airway is different from adults, and thoroughly covers the assessment and management of pediatric airway emergencies.
Over 30 million children seek emergency care each year in U.S. emergency departments. Children represent 30% of emergency department patient visits. By contrast, children represent only 10% of all prehospital calls. Of these calls, less than 5% are life- or limb-threatening. Respiratory complaints comprise 10% of all pediatric prehospital calls and 1% of these patients present in cardiopulmonary arrest from both medical and traumatic causes.
What impact do these statistics have on your practice as an EMS provider?
One of the first decisions EMS providers make when assessing a pediatric patient is whether to manage the patient's medical needs in the field or initiate rapid transport to allow for additional management in the emergency department. Certainly patients with severe conditions such as respiratory failure will require immediate field management to ensure adequate oxygenation and ventilation en route to the hospital. The question of whether to intubate a patient in the field versus providing bag-mask ventilation is a complex one and requires knowledge of what intervention is most effective, has the least complications, and which procedure promises a better outcome. The decision about airway management of pediatric patients in the field versus the emergency department will always require careful consideration and is likely to change with new research and collective experience.
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