Regarding RSI in pediatric patients, we have a general Emergency Department
with a high pediatric volume and manage pediatric intubations as follows:
1) When a child requires rapid sequence intubation in the ED, who
performs the procedure?
The Emergency Physicians perform all pediatric and adult
intubations and almost 100% of our pediatric intubations are with RSI. No
one else is called down to the ED. Depending on the time of day, attending
level anesthesiaology back up may be in house, neonatal back is always in
house but generally never called. In review of last 3 years of
intubations, anesthestia was called for 1 pediatric intubation and
neonatalolgy was called in advance of arrival of a 28 week premie born at
home. All others were done by EM staff.
ED staff has been called on occasion to help in L&D with
intubations when multiple births overextended the neonatal staff.
2) How often is a pediatric resident, with supervision from any of
the above services, the person performing the intubation?
Senior Emergency Medicine residents are present in the department
10 hours a day. If present they make first attempt at RSI of children
under direct supervision of the EM attending.
3) Do you have a predefined upper airway obstruction team?
No. ENT on call from home.
Our Lady of Lourdes Medical Center
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