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Here is our recently approved pediatric ER airway management guideline.

It is very specific to our practice and may not be generalizable to other practices.

Mark Mannebach
Pediatric Emergency Medicine
Mayo Clinic Rochester

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Bob Waddell
Sent: Friday, February 20, 2015 11:22 AM
To: [log in to unmask]
Subject: Re: Airway questions

Look at NAEMSP - Model Pediatric Protocols - outstanding set and has passes NUMEROUS clinical standard of care tests in various disciplines, and they're free!. 

The issue of G tubes prior to BVM is questionable due to "how much benefit does it provide versus the risk?"   One of the issues of the volume and force of bag ventilation specifically related to effectiveness and efficiency of BVMV should be addressed before moving to other procedures which care their own set of implications / complications.

 If you're placing a  G tube in anticipation of an ET, again the risk vs benefit of a rarely used skill with significant clinical implications / complications should be WELL thought out.  

Depending on your system design and resources you may need to review Maryann Gausche's 2000 ish study on pediatric intubation in the prehospital environment.  Amazing study if you put your ego and testosterone level in check - think about the patient and their outcome, not your bag of tricks.

Take care,

Bob Waddell II
(307) 9967030

----- Original Message -----
From: "Matthew Hansen" 
To:
Cc:
Sent:Fri, 20 Feb 2015 14:57:38 +0000
Subject:Airway questions

 We are working on developing an intubation protocol for our PED. Two questions for the group:

 1) Does anyone routinely place a gastric tube prior to intubation in patients who require BVM? This would be to prevent the stomach from becoming distended during BVM and causing difficulty ventilating.

 2) Does anyone have a pediatric intubation protocol or checklist they are willing to share?

 Thanks,
 Matt Hansen

 Matt Hansen MD, MCR
 Assistant Professor of Emergency Medicine  NIH/NHLBI K12 Scholar  Oregon Health Science University

 For more information, send mail to [log in to unmask] with the message: info PED-EM-L  The URL for the PED-EM-L Web Page is:
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html