Читать книгу Emergency Medical Services - Группа авторов - Страница 72

The clinical trial reported by Gausche et al. demonstrated no survival or neurological benefit from prehospital pediatric ETI [10]. Given the strength of these data and the relatively low number of pediatric procedures performed by individual prehospital clincians, some EMS physicians recommend BVM ventilation instead of ETI for critically ill children. Others have dismissed the generalizability of the study. Consequently, prehospital pediatric airway management practices vary across the United States.

Pediatric airways have unique features that may present difficulties for those not accustomed to caring for critically ill children. Since pediatric patients comprise a small proportion of all prehospital ETI, EMS medical directors must weigh the benefits of pediatric ETI against the challenges of providing adequate pediatric airway training and clinical experience. SGA are now available for children. Given broad SGA success in adults, the availability of SGA for children provides an important additional option for prehospital personnel. Pilot and simulator series describe the viability of SGA use in children [66, 67].