All About Airway – Endotracheal Tubes

This week I want to highlight two airway discussion points which have recently come to my attention: cuffed vs. non-cuffed endotracheal tubes (ETTs) in pediatric patients and the possible, negative side effects of supraglottic airways.

Endotracheal Tubes: Cuffed vs non-cuffed

In June, 2012, a memo was released by the BC Children’s Trauma Program advising the use of cuffed ETTs over non-cuffed. I copied the wording below, click the link to see the memo.

“BC Children’s Hospital’s Trauma Program and Pediatric Intensive Care Physicians are requesting that all pediatric trauma and burn patients who require intubation at another facility, be intubated with a CUFFED endotracheal tube. This is currently the standard in the BCCH Emergency Room, Pediatric ICU, and Operating Room.”
 endotracheal tubes
“Uncuffed endotracheal tubes run the risk of large air leaks which make effective ventilation difficult, and may require reintubation with a cuffed tube. The risk of reintubating these patients can be of particular concern in the burn population.”

What does this mean to me? I understand how critical airway management and ventilation is to the unstable pediatric patient. The memo specifies pediatric burn and trauma patients. I wonder how this recommendation applies to a primary respiratory or cardiac arrest pediatric patient?

I look forward to your thoughts and discussions.

Stay tuned for tomorrow’s post on supraglottic airways.