Pediatric Airway Emergency
Laryngospasm
Triggers
Laryngospasm
Tight closure of vocal cords / glottis
ETT removed in light plane of anesthesia
Excessive secretions on/near glottis
Recognition
Recognize Signs
Inability to ventilate
No breath sounds
Sternal & intercostal retractions
Child may be agitated / flailing
Treatment
1
Larson's Maneuver
FIRM jaw thrust with pressure on the angle of the mandible
2
CPAP / Positive Pressure
Consistent pressure on the bag with tight mask seal
⚠ Do NOT bag — goal is to fatigue laryngeal muscles to open glottis
Able to ventilate?
YES
NO
Resolved
Resume airway management
Call for Help
Desaturation occurring
Rescue Treatment
Deepen anesthetic: Propofol
± Paralytic: Succinylcholine