As if communication with young children was not challenging enough, the child presenting with an altered mental status (AMS) is an exceptional opportunity for testing one's sleuthing ability. The reality is that we see far more adults with AMS than we do children. Consequently, we might be tempted for just a moment to doubt our abilities.
By Ronald M. Perkin, MD, MA
Professor and Chairman, Department of Pediatrics, Brody School of Medicine at East Carolina University; Chairman, Committee on Physician Health, Pitt County Memorial Hospital, Greenville, NC; and Jay Weaver, JD, EMT-P, Attorney, Private Practice; Adjunct Faculty, Northeastern University, Boston.
Difficult airway is a broad term that unfortunately encompasses many clinical situations and their potential management options. Airway management difficulties can be divided into those that are predicted and those that are unexpected. They also can require immediate attention (emergent) or be stable (non-emergent). Difficulty can arise at any stage of airway management. Development of a standardized airway assessment and approach to management allows the physician to provide better patient care. Optimal care requires skill in assessing the situation, knowledge of equipment, and finally, how to use it successfully.
