Date Published

February 7, 2025

Updated For

ALS PCS Version 5.2

#SWORBHPTips

Pediatric ​Airway ​Pearls​

Tips and tricks for this respiratory season​

​Part 1: Anatomic differences + Optimizing Pediatric Airway Positioning

  • Respiratory virus season is upon us ​
  • This means an increase in calls for respiratory symptoms, including in the pediatric population​
  • This #SWORBHPTips series will review some pediatric pearls based on anatomic differences in the pediatric airway and how to alter your management strategy to optimize your ventilation in this population​

(see image)

Pediatric Airway Positioning​

  • To obtain the most patent airway, the "sniffing position" is utilized ​
    • In pediatric patients the optimal way to obtain this position varies by age group​
    • Infants have a much larger head vs. body size​
    • Older children are proportionally more like adults​
  • Let's look at how best to obtain this positioning

Sniffing Position: Infant 

Tip: See red arrows​ (see image below)

1) Forehead level with chin, 2) Ear canal level with sternal notch​

Sniffing Position: Child

Tip: See green arrows​ (see image below)

1) Forehead level with chin, 2) Ear canal level with sternal notch​

Summary: Positioning​

  • In order to obtain the optimal airway patency, the sniffing position is utilized​
    • The method to obtain this position is different based on pediatric age group​
      • Infants typically require a shoulder roll due to their large head​
      • Older children are more similar to adults and may require a head rest/roll​​

Stay tuned for more tips on the Pediatric Airway in this #SWORBHPTips series

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