Emergency Front-Of-Neck Access in the Pediatric Intensive Care Unit: Development of an Institutional Protocol.
Paediatric anaesthesia · 2025-11-06 · Other / unclear
Abstract
"Cannot Intubate, Cannot Oxygenate" is a rare but life-threatening situation that requires immediate recognition, advanced airway management, and ultimately emergency front-of-neck access. All airway practitioners caring for children should be prepared to face these situations. The aim of this review was to provide a concise summary of the latest evidence and to propose a streamlined protocol for pediatric emergency front-of-neck access in the intensive care setting. The strength of our protocol is that we have set explicit time limits for front-of-neck access attempts and incorporated extracorporeal membrane oxygenation to achieve the best possible survival and neurological outcomes. No evidence-based consensus exists on the best practice, although organization of local protocols and equipment, as well as regular and comprehensive training, is crucial to bolster clinician confidence and improve patient outcomes.