Category Archives: Paediatric

NAPEM17: Paediatric Procedual Sedation in the ED

Herewith my final presentation from NAPEM 2017 in Hyderabad, India. Not really an airway talk, but in the spirit of #FOAM, I’m reproducing it here.

The SASA Paediatric Procedural Sedation and Analgesia (PSA) Guidelines (2016 Update) are available from the ‘Publications’ section of the SASA web page (and are open access), but for ease of access, I have made the file available here as well:

SASA Paediatric Sedation Guidelines (2016 update)

NAPEM’17: Securing the Paediatric Airway – What’s New?

As promised, my presentation from the 9th National Assembly on Paediatric Emergency Medicine currently being held at the Apollo Institute of Medical Sciences & Research in Hyderabad, India.  There is much more content in the audio, which I will try to add to the post later when it is available.Thoughts? Comments?  Post them below!

NAPEM’17: Paediatric Difficult Airway in the ED

As promised/per usual, here’s my presentation from the current National Assembly on Paediatric Emergency Medicine, being held now (16-19 Feb 2017) at the Apollo Institute of Medical Sciences & Research, Hyderabad, India.  Much of the content is in the audio, of course…which I will post if/when available.
Comments welcome below as usual!

ICEM2016 Pediatric Emergency Medicine Course resources


The first African presentation of the PEMC (Pediatric Emergency Medicine Course) is being run as one of the pre-conference workshops for ICEM 2016 at Red Cross War Memorial Children’s Hospital today.  OpenAirway is present, assisting with the airway stations.  Course instructors have given their blessing to host some of the supplementary material online for the #FOAM community, so we have created a PEMC resources page here!  More content will be added as it becomes available.


Paediatric Bonfils Intubation

Intubation in a young child with a severe submandibular abscess using the paediatric Bonfils rigid intubating endoscope under inhalational general anaesthesia. Direct laryngoscopy showed only severe swelling with a Cormack-Lehane grade 3b view.  A standard laryngoscope was used with the left hand to create an open path for the Bonfils just right of the midline, avoiding the worst of the submandibular swelling.  3.5mm Bonfils allowed intubation with a 4.5 mm uncuffed ETT.  Note that because this is a rigid intubating scope, it is not inserted through the vocal cords, but they are visible through the tube as it is inserted with the Bonfils held steady.

Bougie-assisted intubation snagging on arytenoid

This common problem is worst with small bougies, such as in this paediatric example of a child with severe burns and a difficult airway.  The bevel of the ETT allows the tip of the tube to stick out right (laterally) of the bougie and snag on the right arytenoid cartilage.  This can be remedied by withdrawing the ETT slightly (to disengage it from the arytenoid), effecting a one-quarter counter-clockwise rotation of the ETT on the bougie (bringing the bevel and tip of the ETT into a superior midline position snug with the bougie), and then advancing again.