Endotracheal Intubation in Children

Emergent endotracheal intubation may be performed in the prehospital setting, as well as in emergency departments or other critical care settings. The need for intubation may be immediately apparent, such as in cardiopulmonary arrest.

In other circumstances, the decision to intubate may result from dynamic assessment based on progressive or anticipated deterioration despite maximal medical therapies and non-invasive respiratory support.

Emergency intubation is inherently more difficult to perform than planned intubation in the operating room. Patients are not prescreened and often had recent oral intake as opposed to being in the fasted state (ie, nil per os [NPO]).

In addition, rapid clinical deterioration may compromise preparation time, and underlying illness or injury may make patients more susceptible to the adverse physiologic effects of this procedure.

There are significant differences in airway anatomy and respiratory physiology between children and adults, and these are taken into careful consideration before performing tracheal intubation of any pediatric patient.

The differences, which are quite significant in infants, gradually disappear as the human body approaches a mature age and body mass index.