Supraglottic Airway Device Use During Paediatric Airway Management in the Emergency Department: A Registry Study

Abstract

Background

Supraglottic airway devices (SGAs) are used in airway management to provide non-invasive ventilation and oxygenation. SGAs can be used as rescue tools in failed endotracheal intubation, difficult bag-mask ventilation, or as a bridge to intubation in cardiac arrest.

Objectives

The aim of this study was to describe the frequency of SGA use in children in emergency departments (EDs) across Australia and New Zealand and indications for their use.

Methods

We conducted a retrospective observational study using paediatric data from the Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) to describe the frequency of SGA use in children aged 0–18 years at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites over an 11-year period. Additionally, we surveyed 20 PREDICT sites to identify which SGA were used and describe their positions in their emergency airway management protocols and received 11 responses.

Results

SGAs were used during 14 out of 403 paediatric intubations (3.5%) across 12 PREDICT sites. The overall first pass success rate for intubation was 81.05% (325/401). SGAs were used prior to intubation in 14 cases, and as a rescue device following unsuccessful intubation in one case. Among the surveyed PREDICT EDs, 8 out of 11 (72%) reported having a difficult airway plan that included SGAs as a rescue device following unsuccessful intubation.

Conclusions

SGAs were used infrequently during emergency airway management outside of the operating room. SGA use as a rescue device following unsuccessful intubation was rare, despite their inclusion in most departments' difficult airway plan.

Trial Registration: Australia and New Zealand Clinical Trials Registry: ACTRN12613001052729.