Lesson 242: PreAnesthetic Assessment of the Pediatric Patient With a Difficult Airway

hen managing the airway of a pediatric patient, an anesthesiologist must have more than a practical familiarity with the anatomic differences between the airways of adults and children. It is crucial that the clinician take a proper medical history and perform a physical examination before selecting equipment for intubation. The clinician must also evaluate the patient for any potential congenital syndromes that can complicate an intubation. Securing the difficult airway requires cooperation and planning with pediatricians, otolaryngologists, and pulmonologists. Guided by professional judgment and the preoperative examination findings, the anesthesiologist should be able to foresee and prevent complications during perianesthetic management. In all instances, a difficult airway cart should be available with equipment that is sized for the child (Table 1). The contents of this cart should be prepared and frequently reviewed by the anesthesiologist.