Assessing and preparing for airway management in pediatric patients is a crucial step in preoperative care, particularly when anesthesia or sedation is required. The primary goal is to identify any potential challenges that may arise during airway management to prevent perioperative complications. While the general principles of airway evaluation—such as a thorough history, physical examination, and use of scoring systems—apply to both adults and children, pediatric patients require additional considerations due to their distinct anatomical and physiological features.
The assessment begins with a detailed airway history, which includes reviewing past medical records, especially any previous anesthesia encounters. This history should include specifics like the ease of mask ventilation, the need for airway adjuncts, the type of laryngoscope used, the number of intubation attempts, and the laryngoscopic view obtained (often classified using the Cormack and Lehane scale). This information helps to establish whether the child has experienced airway difficulties in the past and serves as the foundation for planning future airway management.
In addition to the airway history, it is essential to explore the child's broader medical history, paying particular attention to any congenital anomalies or syndromes that could complicate airway management. Conditions like Pierre Robin sequence, Treacher Collins syndrome, Goldenhar syndrome, or obstructive sleep apnea (OSA) can increase the risk of difficult airway management. Even relatively minor symptoms, such as a history of upper respiratory infections, hoarseness, or noisy breathing, can signal potential airway challenges.
