Pediatric Ventilator Management in the Emergency Department - 04/04/18

Doi : 10.1016/j.emc.2017.12.008

Garrett S. Pacheco, MD ^a,^b,^⁎ , Jenny Mendelson, MD ^a,^b,^c, Mary Gaspers, MD ^c
^a Department of Emergency Medicine, University of Arizona College of Medicine, Banner University Medical Center Tucson, 1501 North Campbell Avenue, PO Box 245057, Tucson, AZ 85724
^b Department of Pediatrics, University of Arizona College of Medicine, Banner University Medical Center Tucson, 1501 North Campbell Avenue, PO Box 245057, Tucson, AZ 85724
^c Pediatric Critical Care Medicine, Department of Pediatrics, University of Arizona College of Medicine, Banner University Medical Center Tucson, 1501 North Campbell Avenue, PO Box 245057, Tucson, AZ 85724

^∗Corresponding author. Department of Emergency Medicine, University of Arizona College of Medicine, Banner University Medical Center Tucson, 1501 North Campbell Avenue, PO Box 245057, Tucson, AZ 85724.Department of Emergency MedicineUniversity of Arizona College of MedicineBanner University Medical Center Tucson1501 North Campbell AvenuePO Box 245057TucsonAZ85724

Résumé

Pediatric mechanical ventilation is first initiated by emergency physicians when performing active airway management in a critically ill or injured child. When initiating and adjusting mechanical ventilation, the child has unique anatomy and physiology to consider. The EP is the first to respond to ventilator alarm triggers, and the initial medical provider to resuscitate the ventilated pediatric patient who is deteriorating while in the emergency department. This article uses cases to provide a framework to initiate and troubleshoot mechanical ventilation of pediatric patients in the emergency department.

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Keywords : Mechanical ventilation, Airway, Pediatric, Blood gas analysis, Ventilator alarm, Hemodynamic instability