Pediatric Intubation – Pediatric Advanced Life Support (PALS)

I recently completed my Pediatric Advanced Life Support (PALS) recertification and the key to PALS and pediatric emergency management is, along with high quality Basic Life Support, high quality airway management*. Hence this post about pediatric airway management.

See the 2015 Handbook of Emergency Cardiovascular Care for Healthcare Providers see the pediatric resuscitation sizing chart p. 94 – Pediatric Resuscitation Supplies Based on Color Coded Resuscitation Tape. What follows are excerpts from Handbook:

Estimating Endotracheal Tube Size and Depth of Insertion

Pediatric Tube Size                                                                                                                                   Several formulas, such as the ones below, allow estimation of proper endotracheal  tube size (internal diameter [i.d.]) for children 2 to 10 years of age, based on the child’s age:

Uncuffed endotracheal tube size (mm i.d.) = (age in years/4) + 4

During preparation for intubation, providers also should have ready at the bedside uncuffed tubes 0.5 mm smaller and larger than that estimated from the above formula.

The formula for estimation of a cuffed endotracheal tube size as follows:

Cuffed endotracheal tube size (mm i.d.) = (age in years/4) + 3.5

Typical cuffed inflation pressure should be <20 to 25 cm H2O.

Depth of Insertion                                                                                                                     The formula for estimation of depth of insertion (measured at the lip) can be estimated from the child’s age or the tube size.

Depth of insertion (cm) for children >2 years of age = (age in years/2) + 12                     or                                                                                                                                                                Depth of insertion = tube i.d. (mm)  x 3                                

For information on how to make your own Pediatric Color Co ded Tape, see my post “Make Your Own Color Pediatric Color Coded Resuscitation Tape [coming soon].

 

*To access all the my site’s airway management blog posts, most of which are simply links to YouTube videos, simply type airway in to the search box which is on the very top of the right hand column or click on airway in the categories list just below the search box.

*To access all my site’s Pediatric  Advanced Life Support posts, simply type in pediatric advanced life support in to the search box which is on top of the right hand column or click on Pediatric Advanced Life Support in the categories list just below the search box.

https://m.youtube.com/watch?v=166GYtQd2Z4

 

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https://www.youtube.com/watch?v=tjpIMrmwJks

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