5 Key Factors for Managing Airways in Children

Respiratory issues are common in children. Choking remains a leading cause of childhood injury and death. About 1 percent of newborns experience respiratory distress, and respiratory issues are the leading cause of death among premature infants. Drowning and aspiration are relatively common. An injured or sick child is always a crisis, and caregivers may be panicking as you tend to their beloved little one. The following tips can help you masterfully treat children in a way that saves their lives, protects their dignity, and reassures their caregivers. 


Treat Children with Respect 

Children, especially very young kids, are notoriously uncooperative in medical settings. They don’t understand that painful shots can save their lives and that doctors and other care providers really do want to help them. They may fight back, throw tantrums, or refuse to listen. Understanding that these reactions are rooted in fear is key to supporting the kids who have them. Treat children with respect and dignity. Do not restrain them unless doing so is absolutely the only way to keep them safe. Never yell at or shame them, and do not make fun of them for being afraid. Instead, show them that you care by remaining calm and compassionate, and explaining the procedure in terms they can understand. Offer continual reassurance, and guide them through the process by telling them which step comes next and when the process is almost complete. 


One simple rule you can apply here is this: Don’t do something to a child that you wouldn’t do to an adult. Children are people with feelings, too, and they will remember how adults treated them during a medical emergency. Some research even suggests that early experiences with restraint or fear of being restrained may lead to later phobias. So proceed with caution and treat children as autonomous people whose needs matter. 


Involve Caregivers as Much as Possible

Watching a child choke or struggle to breathe may be the single most terrifying experience of a parent’s life. Involve the parents as much as possible by telling them what you are doing. If they can safely do so, allow the parent to comfort and talk to their child. Delaying information can spark panic, which may cause both the child and parent to become less cooperative. 


Identify the Unique Needs of the Neonate

Neonates are obligate nose breathers with much smaller airways. This makes them more susceptible to serious complications from respiratory infections. Nostril flaring and retractions in a newborn constitute a medical emergency, and neonates must be transported for further testing and observation. 


Understand Anatomical Differences

Providers must be mindful of several critical airway differences. In neonates, breathing is primarily accomplished through the nose, and so a nasal blockage can severely compromise respiration. In babies and older children, consider the following


  • Infants often have cave-like chests that can affect respiratory sounds. 
  • Pediatric patients have relatively larger tongues that can make intubation more challenging. 
  • The glottis tends to be higher in infants and young children. 
  • The cricothyroid membrane is small, making a cricothyrotomy difficult, and sometimes even impossible. 
  • The tonsils and adenoids tend to be relatively larger. 
  • The trachea is narrower, necessitating smaller suction and intubation equipment. 


Blind intubation in young children is more dangerous because of these anatomical differences. 


Use the Right Equipment 

Providers who treat young children should have child-sized equipment available at all times, including smaller and more flexible catheters. Because children can suffer respiratory distress anyway, it is also important to have a portable emergency suction machine. These machines save lives when seconds count, empowering healthcare providers to treat children without undertaking the risk of moving them. 

For help selecting the perfect suction machine for your agency, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.