PURPOSE: Pediatric prehospital endotracheal intubation (PHETI) is a difficult and rarely performed procedure that remains the gold standard for prehospital airway management when ventilation and/or anesthesia is required, but high complications rates, including malposition continue to concern. We reviewed the experience in our institution of pediatric intubations with particular emphasis on the position of the endotracheal tube (ETT) tip within the @entity825 and related complications. METHOD: Intubated pediatric @entity1 presenting directly from the scene to our level 1 @entity130 center, between 2006 and 2014, were included in our study. @entity1 records and radiographs were retrospectively reviewed to identify the ETT tip-to-carina distance and possible intubation-related complications. ETT tips identified beyond the carina on radiographs or by clinical diagnosis were defined as misplaced. Because @entity910 causes a significant ETT movement within the @entity825 , which is age related, we also defined ETT tip placement (1) less than 2  cm above the carina in @entity1 younger than 8 and (2) less than 3  cm above the carina in @entity1 8  years or older as "near miss" intubations. RESULTS: From a total of 34 cases, ETT misplacement was identified in seven cases. Diagnosis was made radiologically in five cases and clinically in two cases. Four of these @entity1 had @entity358 due to tube misplacement. Tube thoracotomy was performed in two of these @entity1 without concurrent evidence of @entity764 . "Near miss" intubations accounted for 7/9 and 9/25 in @entity1   <8  years and >= 8  years old, respectively, totaling 16/34, with two of these leading to late displacements. CONCLUSIONS: Pediatric endotracheal tube intubation carries a high rate of tube malposition and @entity358 in our experience of pediatric @entity130 @entity1 , with less than a third of ETTs placed in a safe position.

Radiological evaluation of tube depth and complications of prehospital endotracheal intubation in pediatric XXXX : a descriptive study.

@entity825 :: ('MESH:D055090', 'Disease') :: ['trachea'] @entity1 :: ('9606', 'Species') :: ['children', 'patients', 'Patient'] @entity910 :: ('MESH:D004409', 'Disease') :: ['head movement'] @entity358 :: ('MESH:D008171', 'Disease') :: ['left lung atelectasis'] @entity764 :: ('MESH:D013898', 'Disease') :: ['chest injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity130 :: (MESH:D014947,Disease) :: ['trauma']
