{"id":6011,"date":"2024-04-07T23:44:57","date_gmt":"2024-04-07T23:44:57","guid":{"rendered":"https:\/\/paeder.com\/24-04-avoid-damage-due-to-intubation"},"modified":"2024-09-29T14:34:06","modified_gmt":"2024-09-29T14:34:06","slug":"24-04-avoid-damage-due-to-intubation","status":"publish","type":"post","link":"https:\/\/paeder.com\/en\/24-04-avoid-damage-due-to-intubation","title":{"rendered":"24-04 Avoid damage due to intubation"},"content":{"rendered":"<div class='flex_column av-rmagbc-cf477fd8f5a21cbd9ab4568ed7678708 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-puf2jc-dcd31172590fec08bba7b89421c4baf8 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-2f97c8-5665d41d9a52b0bf6351c9eb4841cfd4\">\n.avia-image-container.av-2f97c8-5665d41d9a52b0bf6351c9eb4841cfd4 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-2f97c8-5665d41d9a52b0bf6351c9eb4841cfd4 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-2f97c8-5665d41d9a52b0bf6351c9eb4841cfd4 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-5974 avia-img-lazy-loading-not-5974 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761.jpg\" alt='' title='Header Intubieren 1920 x 761'  height=\"761\" width=\"1920\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761.jpg 1920w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-300x119.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-1030x408.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-768x304.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-1536x609.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-1500x595.jpg 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-705x279.jpg 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-1920-x-761-450x178.jpg 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Header-Intubieren-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-mrel2w-a0362097d61d9faa2c283089ed576655\">\n#top .hr.hr-invisible.av-mrel2w-a0362097d61d9faa2c283089ed576655{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-mrel2w-a0362097d61d9faa2c283089ed576655 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-klrvig-4b45468fe515bb62bd037a284f2a5da8'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: right;\">April 8, 2024<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e\">\n#top .av-special-heading.av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e{\npadding-bottom:10px;\ncolor:#fc0001;\n}\nbody .av-special-heading.av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e .special-heading-inner-border{\nborder-color:#fc0001;\n}\n.av-special-heading.av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-jh6r7c-44e59752d3f727c9dc1c789ea844cb4e 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\"  >Avoid damage due to intubation<\/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-1p8k7c-c30c4c1e6b145d3014688c5849eb795e\">\n#top .hr.hr-invisible.av-1p8k7c-c30c4c1e6b145d3014688c5849eb795e{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-1p8k7c-c30c4c1e6b145d3014688c5849eb795e 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-fbwyew-3e38873e6e15cb1aeacef207031c7194'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>The ERC guidelines point out that only experienced persons should attempt to intubate a child prehospital. This applies not only to the intubation procedure, but also to experience with the dosage and properties of the medication <sup>used1<\/sup>!  <\/strong>  Even in the event of resuscitation, polytrauma or intracranial pressure, children do not benefit from endotracheal intubation! Aspirations pose little threat in childhood, but damage caused by hypoxia is very serious! Therefore, intubation should never be forced desperately. Supraglottic airway devices should be used instead. For the same reason, intermediate ventilation should always be carried out for intubation in a non-sober <sup>child2<\/sup>.  <\/p>\n<p class=\"EndNoteBibliography\"><span style=\"color: #333333;\">However, if endotracheal intubation is to be performed, these are <strong>the most important rules for avoiding intubation damage and complications<\/strong>:  <strong><br \/>\n<\/strong><\/span><\/p>\n<p class=\"EndNoteBibliography\">\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-luq6fai2-5c2b056fc1ae5418949535c484d3a19f\">\n.avia-image-container.av-luq6fai2-5c2b056fc1ae5418949535c484d3a19f img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-luq6fai2-5c2b056fc1ae5418949535c484d3a19f .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-luq6fai2-5c2b056fc1ae5418949535c484d3a19f av-styling- avia-align-center  avia-builder-el-8  el_after_av_textblock  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-5968 avia-img-lazy-loading-not-5968 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3.jpg\" alt='' title='Druck'  height=\"2481\" width=\"2480\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3.jpg 2480w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-300x300.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-1030x1030.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-80x80.jpg 80w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-768x768.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-1536x1536.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-2048x2048.jpg 2048w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-36x36.jpg 36w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-180x180.jpg 180w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-1500x1500.jpg 1500w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-705x705.jpg 705w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-120x120.jpg 120w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-450x450.jpg 450w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-600x600.jpg 600w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Handlungsanweisung-Intubation-Ablauf-3-100x100.jpg 100w\" sizes=\"(max-width: 2480px) 100vw, 2480px\" \/><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-dv5b2g-4ec20538ede5bc8955f9c1e56ec6be50\">\n#top .hr.hr-invisible.av-dv5b2g-4ec20538ede5bc8955f9c1e56ec6be50{\nheight:40px;\n}\n<\/style>\n<div  class='hr av-dv5b2g-4ec20538ede5bc8955f9c1e56ec6be50 hr-invisible  avia-builder-el-9  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-luq6njdo-cab55da0aa335a6fed951aeb679b0568'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Safety in the selection of the appropriate tube size is provided by Table 1 or the use of the Pediatric Emergency Ruler PedNFL for the demonstrably most precise estimation of the tube <sup>size3<\/sup>. If, despite the above precautions, stridor occurs after extubation and does not stop after inhalation of \u00df-mimetics and administration of corticosteroids, an endoscopy of the larynx should be performed quickly. With the transglottic injection of a depot corticosteroid, 80% of severe damage that would otherwise have required a tracheostomy can be cured<a href=\"https:\/\/paeder.com\/?nltr=MjM7ODQzODtodHRwczovL3BhZWRlci5jb20vd3AtY29udGVudC91cGxvYWRzLzIwMjMvMDQvUERGXzc1LnBkZjs7N2NhNDZkYjJlMzZkZTczNDQ4ZGY2NTQzNTM1OWI4NzM%3D\"><sup>4<\/sup><\/a>. <strong><span style=\"color: #c00d0d;\">NOTE: Intubation trauma can be healed by a rapid transglottic injection of cortisone, thus avoiding a tracheostomy.<\/span><\/strong><strong>Table 1:<\/strong><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3k1ea0-47952c5a2eb598451dd8ef4087fcfbe5\">\n#top .hr.hr-invisible.av-3k1ea0-47952c5a2eb598451dd8ef4087fcfbe5{\nheight:40px;\n}\n<\/style>\n<div  class='hr av-3k1ea0-47952c5a2eb598451dd8ef4087fcfbe5 hr-invisible  avia-builder-el-11  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-luq6jovu-28bd5d6d8631c8dd17532e203750edcb\">\n.avia-image-container.av-luq6jovu-28bd5d6d8631c8dd17532e203750edcb img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-luq6jovu-28bd5d6d8631c8dd17532e203750edcb .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-luq6jovu-28bd5d6d8631c8dd17532e203750edcb av-styling- avia-align-center  avia-builder-el-12  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-5964 avia-img-lazy-loading-not-5964 avia_image ' src=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1.jpg\" alt='' title='Druck'  height=\"2481\" width=\"2480\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1.jpg 2480w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-300x300.jpg 300w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-1030x1030.jpg 1030w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-80x80.jpg 80w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-768x768.jpg 768w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-1536x1536.jpg 1536w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-2048x2048.jpg 2048w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-36x36.jpg 36w, https:\/\/paeder.com\/wp-content\/uploads\/2024\/04\/Grafik-Auswahl-Tubusgroesse-1-180x180.jpg 180w, 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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-ba2ts8-5d3d9a3f8a366af4db1778f6d3d7b4fc\">\n#top .hr.hr-invisible.av-ba2ts8-5d3d9a3f8a366af4db1778f6d3d7b4fc{\nheight:20px;\n}\n<\/style>\n<div  class='hr av-ba2ts8-5d3d9a3f8a366af4db1778f6d3d7b4fc hr-invisible  avia-builder-el-15  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-8gnf60-816728b3a1b1676c78a7159395bf4b9b'  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>Schmidt J, Strau\u00df JM, Becke K. Recommendations for rapid sequence induction in children. Anaesth Intensivmed 2007; 48: S88-93<\/li>\n<li>Hofer CK, Ganter M, Tucci M et al. How reliable is length-based determination of body weight and tracheal tube size in the paediatric age group? The Broselow tape reconsidered. Br J Anaesth 2002; 88: 283-285<\/li>\n<li><span lang=\"EN-US\"><a href=\"https:\/\/paeder.com\/?nltr=MjM7ODQzODtodHRwczovL3BhZWRlci5jb20vd3AtY29udGVudC91cGxvYWRzLzIwMjMvMDQvUERGXzc1LnBkZjs7N2NhNDZkYjJlMzZkZTczNDQ4ZGY2NTQzNTM1OWI4NzM%3D\">Kaufmann J, Bode K, Puder C et al. Transglottic corticosteroid injection for treatment of soft post-intubation subglottic stenosis: a retrospective analysis of 26 children. Eur Arch Otorhinolaryngol 2019; 276: 3419-3424, DOI: 10.1007\/s00405-019-05642-y  <\/a><\/span><\/li>\n<\/ol>\n<\/div><\/section><br \/>\n<div  class='av-social-sharing-box av-7iahug-c29813eccc66280e03131f04c71b1a0e av-social-sharing-box-default  avia-builder-el-17  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\/24-04-avoid-damage-due-to-intubation&#038;t=24-04%20Avoid%20damage%20due%20to%20intubation' 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 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