{"id":5797,"date":"2024-02-25T18:07:41","date_gmt":"2024-02-25T18:07:41","guid":{"rendered":"https:\/\/paeder.com\/24-02-spoon-with-light"},"modified":"2024-09-29T14:33:45","modified_gmt":"2024-09-29T14:33:45","slug":"24-02-spoon-with-light","status":"publish","type":"post","link":"https:\/\/paeder.com\/en\/24-02-spoon-with-light","title":{"rendered":"24-02 Spoon with light"},"content":{"rendered":"<div class='flex_column av-mpppk2-090282fafae7318e58cd0f991f563b9c av_one_fifth  avia-builder-el-0  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div '     ><\/div>\n<div class='flex_column av-kbocxe-2f0e87b12bd7c0243a67e8cac44efe51 av_three_fifth  avia-builder-el-1  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lt1ti1cn-bd71a908dd6c003ada70a80ef71ed452\">\n.avia-image-container.av-lt1ti1cn-bd71a908dd6c003ada70a80ef71ed452 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-lt1ti1cn-bd71a908dd6c003ada70a80ef71ed452 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-lt1ti1cn-bd71a908dd6c003ada70a80ef71ed452 av-styling- avia-align-center  avia-builder-el-2  el_before_av_hr  avia-builder-el-first '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-5755 avia-img-lazy-loading-not-5755 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761.jpg\" alt='' title='Header Loeffel mit Licht 1920 x 761'  height=\"761\" width=\"1920\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761.jpg 1920w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-300x119.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-1030x408.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-768x304.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-1536x609.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-1500x595.jpg 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-705x279.jpg 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-450x178.jpg 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Header-Loeffel-mit-Licht-1920-x-761-600x238.jpg 600w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-iqdlo2-99174747e6882c07f4872435c29706d9\">\n#top .hr.hr-invisible.av-iqdlo2-99174747e6882c07f4872435c29706d9{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-iqdlo2-99174747e6882c07f4872435c29706d9 hr-invisible  avia-builder-el-3  el_after_av_image  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-lt1tig5o-47aefc9baffd3b582d03d3bebfc31333'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: right;\">February 25, 2024<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lt1tj76u-31b7d1ae768cea52d1423069d54db715\">\n#top .av-special-heading.av-lt1tj76u-31b7d1ae768cea52d1423069d54db715{\npadding-bottom:10px;\ncolor:#fc0001;\n}\nbody .av-special-heading.av-lt1tj76u-31b7d1ae768cea52d1423069d54db715 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-lt1tj76u-31b7d1ae768cea52d1423069d54db715 .special-heading-inner-border{\nborder-color:#fc0001;\n}\n.av-special-heading.av-lt1tj76u-31b7d1ae768cea52d1423069d54db715 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lt1tj76u-31b7d1ae768cea52d1423069d54db715 av-special-heading-h2 custom-color-heading  avia-builder-el-5  el_after_av_textblock  el_before_av_hr '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >For ventilation problems:<br \/>Spoon with light can save lives<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-h69xc2-59e34f2fa036af2783280cf0ce3710af\">\n#top .hr.hr-invisible.av-h69xc2-59e34f2fa036af2783280cf0ce3710af{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-h69xc2-59e34f2fa036af2783280cf0ce3710af hr-invisible  avia-builder-el-6  el_after_av_heading  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-lt1tnqi9-1a90f60893182cf19933beeefd89613c'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><span style=\"color: #000000;\"><strong>In contrast to adults, ventilation is the most important measure in the resuscitation of children or in serious emergencies, because chest compressions alone are NOT suitable for <sup>children1<\/sup>! On the one hand, it is almost impossible for the small organism to survive without ventilation; on the other hand, there is a very high probability that the circulation will be reactivated quickly with ventilation!<\/strong><\/span><\/p>\n<p class=\"EndNoteBibliography\"><span style=\"color: #333333;\">If mask ventilation is not successful, it is all the more important to know a clear course of action! I have shown it in this illustration:<strong><br \/>\n<\/strong><\/span><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lt1tzksz-09ac9dc9bc6cea3e4df15f0d93d02e54\">\n#top .hr.hr-invisible.av-lt1tzksz-09ac9dc9bc6cea3e4df15f0d93d02e54{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-lt1tzksz-09ac9dc9bc6cea3e4df15f0d93d02e54 hr-invisible  avia-builder-el-8  el_after_av_textblock  el_before_av_image '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lt1tpdgs-4ac0474b3e4d43c0d4bafef2ae80585e\">\n.avia-image-container.av-lt1tpdgs-4ac0474b3e4d43c0d4bafef2ae80585e img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-lt1tpdgs-4ac0474b3e4d43c0d4bafef2ae80585e .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-lt1tpdgs-4ac0474b3e4d43c0d4bafef2ae80585e av-styling- avia-align-center  avia-builder-el-9  el_after_av_hr  el_before_av_hr '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" class='wp-image-5862 avia-img-lazy-loading-not-5862 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2.png\" alt='' title='Grafik Handlungsanweisung keine Maskenbeatmung 120 dpi RGB'  height=\"992\" width=\"992\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2.png 992w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-300x300.png 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-80x80.png 80w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-768x768.png 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-36x36.png 36w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-180x180.png 180w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-705x705.png 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-120x120.png 120w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-450x450.png 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-600x600.png 600w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/02\/Grafik-Handlungsanweisung-keine-Maskenbeatmung-120-dpi-RGB-2-100x100.png 100w\" sizes=\"(max-width: 992px) 100vw, 992px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1ylho2-356b5a87de72c5f0d519518bf9f0dd0c\">\n#top .hr.hr-invisible.av-1ylho2-356b5a87de72c5f0d519518bf9f0dd0c{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-1ylho2-356b5a87de72c5f0d519518bf9f0dd0c hr-invisible  avia-builder-el-10  el_after_av_image  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-f5z1mq-8236312f69f059eda0dee2d3559eccb8'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p>The measures shown in the illustration should be escalated step by step from top to bottom until the child is successfully ventilated. The scheme shown largely corresponds to the recommendations of the Scientific Working Group on Pediatric Anesthesia (WAKKA) of the German Society of Anesthesiology and Intensive Care Medicine (DGAI<sup>)1,2.<\/sup> From my point of view and in my scheme, however, a laryngoscopy &#8211; especially preclinically &#8211; should be performed earlier than mentioned here in order to recognize a possible obstruction of the oropharynx with a foreign body or secretions. The laryngoscope is very valuable here, although the eponymous low position in front of the larynx, as in intubation, is not required. Often, simply opening and illuminating the mouth can detect the problems mentioned and enable suction or grasping with Magill forceps.  <strong>This is the reason why I refer to this instrument not as a laryngoscope but as a &#8220;spoon with light&#8221; during lectures and training courses.  <\/strong><\/p>\n<p><span style=\"color: #c00d0d;\"><strong>Remember: Always look in the mouth early if there are ventilation problems!<\/strong><\/span>  It is unlikely that ventilation will not be possible if the measures shown are implemented immediately and in full, at the latest when the laryngeal mask is used. Based on my own experience, I do not agree with the WAKKA recommendations that invasive procedures (coniotomy, tracheostomy, surgical airway) are never necessary. A puncture coniotomy is not easy to perform on small children and infants, as this is the narrowest part of the child&#8217;s airway. The short neck forces the user to make a very steep puncture3<sup>,4<\/sup>. Therefore, a puncture tracheostomy &#8211; also difficult &#8211; should rather be attempted, in which a shallower puncture can be made and the trachea offers a larger lumen <sup>5,6<\/sup>. If at all possible, however, a surgical opening of the trachea should be preferred, which an experienced surgeon (including pediatric surgeons) can perform within a few <sup>minutes7<\/sup>. This is much easier than in adults, where the thyroid gland often causes difficulties along the <sup>way8<\/sup>.  <\/p>\n<h3><span style=\"color: #333333;\"><strong>Security in seconds  <\/strong><\/span><\/h3>\n<p>  The pediatric emergency ruler (P\u00e4dNFL) helps when it comes to the correct dosage of life-saving medication in a child emergency. It enables the length-related weight of the small patient to be estimated immediately and displays the corresponding dosage recommendations. In addition, the PedNFL provides an overview of suitable equipment and standard values at a glance according to the child&#8217;s height and weight. The PedNFL is the only medical aid in the world that has been proven to prevent 9 out of 10 incorrect doses9<sup>,10<\/sup>. It is therefore expressly recommended in the S2k guideline &#8220;Drug safety in pediatric emergencies &#8220;<sup>11<\/sup>.<sup><br \/>\n<\/sup><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-efj6nm-6d982203965d7ba7fbebb38bdb7d71b7\">\n#top .hr.hr-invisible.av-efj6nm-6d982203965d7ba7fbebb38bdb7d71b7{\nheight:40px;\n}\n<\/style>\n<div  class='hr av-efj6nm-6d982203965d7ba7fbebb38bdb7d71b7 hr-invisible  avia-builder-el-12  el_after_av_textblock  el_before_av_button '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<div  class='avia-button-wrap av-ctkmwy-d3b9bd359c21ab65f95b7bb7ea65d536-wrap avia-button-center  avia-builder-el-13  el_after_av_hr  el_before_av_hr ' >\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-ctkmwy-d3b9bd359c21ab65f95b7bb7ea65d536\">\n#top #wrap_all .avia-button.av-ctkmwy-d3b9bd359c21ab65f95b7bb7ea65d536{\nfont-size:20px;\nbackground-color:#ffcd00;\nborder-color:#ffcd00;\ncolor:#444444;\n-webkit-transition:all 0.4s ease-in-out;\n-moz-transition:all 0.4s ease-in-out;\n-ms-transition:all 0.4s ease-in-out;\n-o-transition:all 0.4s ease-in-out;\ntransition:all 0.4s ease-in-out;\n}\n<\/style>\n<a href='https:\/\/paeder.com\/shop'  class='avia-button av-ctkmwy-d3b9bd359c21ab65f95b7bb7ea65d536 avia-icon_select-yes-left-icon avia-size-large avia-position-center' ><span class='avia_button_icon avia_button_icon_left' aria-hidden='true' data-av_icon='\ue859' data-av_iconfont='entypo-fontello'><\/span><span class='avia_iconbox_title' >Order the P\u00e4dNFL\/P\u00e4dOP here<\/span><\/a><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-bjz1oy-743854d9c80d527f54255d7acd41a0fd\">\n#top .hr.hr-invisible.av-bjz1oy-743854d9c80d527f54255d7acd41a0fd{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-bjz1oy-743854d9c80d527f54255d7acd41a0fd hr-invisible  avia-builder-el-14  el_after_av_button  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-9i5aoi-260edfb59080e8801d1c05da3df01491'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p class=\"EndNoteBibliography\"><strong>Literature:<\/strong><\/p>\n<ol>\n<li>Van de Voorde P, Turner NM, Djakow J et al. European Resuscitation Council Guidelines 2021: Paediatric Life Support. Resuscitation 2021; 161: 327-387, DOI: 10.1016\/j.resuscitation.2021.02.015.<\/li>\n<li>Weiss M, Schmidt J, Eich C et al. Recommendations for the prevention and treatment of the unexpectedly difficult airway in pediatric anesthesia. Anaesth Intensivmed 2011; 52: S54-S63<\/li>\n<li>Cote CJ, Hartnick CJ. Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children? Paediatr Anaesth 2009; 19 Suppl 1: 66-76, DOI: 10.1111\/j.1460-9592.2009.02996.x<\/li>\n<li>Navsa N, Tossel G, Boon JM. Dimensions of the neonatal cricothyroid membrane &#8211; how feasible is a surgical cricothyroidotomy? Paediatr Anaesth 2005; 15: 402-406<\/li>\n<li>Johansen K, Holm-Knudsen RJ, Charabi B et al. Cannot ventilate-cannot intubate an infant: surgical tracheotomy or transtracheal cannula? Paediatr Anaesth 2010; 20: 987-993, DOI: 10.1111\/j.1460-9592.2010.03417.x<\/li>\n<li>Disma N, Asai T, Cools E et al. Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines. Br J Anaesth 2024; 132: 124-144, DOI: 10.1016\/j.bja.2023.08.040<\/li>\n<li>Holm-Knudsen RJ, Rasmussen LS, Charabi B et al. Emergency airway access in children &#8211; transtracheal cannulas and tracheotomy assessed in a porcine model. Pediatric Anesthesia 2012; 22: 1159-1165, DOI: 10.1111\/pan.12045<\/li>\n<li>Berger-Estilita J, Wenzel V, Luedi MM et al. A Primer for Pediatric Emergency Front-of-the-Neck Access. A&amp;A practice 2021; 15: e01444, DOI: 10.1213\/XAA.0000000000001444<\/li>\n<li>Kaufmann et al. Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors. Prehosp Emerg Care 2018; 22: 252-259.<\/li>\n<li>Kaufmann et al. Improving Pediatric Drug Safety in Prehospital Emergency Care-10 Years on. J Patient Saf 2021; 17: e1241-e1246.<\/li>\n<li class=\"EndNoteBibliography\">Kaufmann et al. S2k guideline 027\/071: &#8220;Drug safety in pediatric emergencies&#8221;. org 2021<\/li>\n<\/ol>\n<\/div><\/section><br \/>\n<div  class='av-social-sharing-box av-p7m82-468357e9c5cbd793bfb8e193b26fd70c av-social-sharing-box-default  avia-builder-el-16  el_after_av_textblock  el_before_av_hr  av-social-sharing-box-fullwidth'><div class=\"av-share-box\"><h5 class='av-share-link-description av-no-toc '>Share post<\/h5><ul class=\"av-share-box-list noLightbox\"><li class='av-share-link av-social-link-facebook' ><a target=\"_blank\" aria-label=\"Share on Facebook\" href='https:\/\/www.facebook.com\/sharer.php?u=https:\/\/paeder.com\/en\/24-02-spoon-with-light&#038;t=24-02%20Spoon%20with%20light' aria-hidden='false' data-av_icon='\ue8f3' data-av_iconfont='entypo-fontello' title='' data-avia-related-tooltip='Share on Facebook' rel=\"noopener\"><span class='avia_hidden_link_text'>Share on Facebook<\/span><\/a><\/li><li class='av-share-link av-social-link-twitter' ><a target=\"_blank\" 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