• Mattias Renberg, Daniel Hertzberg, Daniel Kornhall, Mattias Günther, and Mikael Gellerfors.
• Department of Anesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden.
• Prehosp Disaster Med. 2021 Oct 1; 36 (5): 547-552.

IntroductionPrehospital pediatric tracheal intubation (TI) is a possible life-saving intervention that requires adequate experience to mitigate associated complications. The pediatric airway and respiratory physiology present challenges in addition to a relatively rare incidence of prehospital pediatric TI.Study ObjectiveThe aim of this study was to describe characteristics and outcomes of prehospital TI in pediatric patients treated by critical care teams.MethodsThis is a sub-group analysis of all pediatric (<16 years old) patients from a prospective, observational, multi-center study on prehospital advanced airway management in the Nordic countries from May 2015 through November 2016. The TIs were performed by anesthesiologists and nurse anesthetists staffing six helicopter and six Rapid Response Car (RRC) prehospital critical care teams.ResultsIn the study, 74 children were tracheal intubated, which corresponds to 3.7% (74/2,027) of the total number of patients. The pediatric patients were intubated by very experienced providers, of which 80% had performed ≥2,500 TIs. The overall TI success rate, first pass success rate, and airway complication rate were in all children (<16 years) 98%, 82%, and 12%. The corresponding rates among infants (<2 years) were 94%, 67%, and 11%. The median time on scene was 30 minutes.ConclusionThis study observed a high overall prehospital TI success rate in children with relatively few associated complications and short time on scene, despite the challenges presented by the pediatric prehospital TI.

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