Pediatric Tracheal Injury
- Trach injuries- 15-50% mortality in 1st hour
- Goals- control airway, ensure respiratory sufficiency
- Anatomic differences- large mandible, head and short neck
Indications for Intubation after Neck Trauma
- stridor, dyspnea, hypoxia, expanding hematoma,
- If pt is "stable," call anaesthesia, tube in OR with bronch
- If more critical; try awake or minimally sedated intubation (Ketamine and no paralytic), prep surg airway, fiberoptic scope
INTUBATION CAN GO BADLY... so be careful! You can disrupt tenuous attachment of trachea and it will retract back into chest (super bad).
- Primary: hereditary or genetic causes antibody related, B and T cell deficiency
- Secondary- acquired
- Red flags for primary immunodeficiency
- family hx, FTT, IV abx and hospitalization to clear infection, recurrent candidiasis, recurrent abscesses, chronic diarrhea
- >6 infections/yr, >2 serious sinus infxn or pneumonias, >2 sepsis/meninigitis in lifetime
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