Set-Up For Success

Normally, intubating children produces angst because we're worried if we miss, but overall they tend to be straightforward as long as you do a few simple things. For young kids, you should have their ear at the level of their anterior shoulder, perhaps put a towel under their shoulder to compensate for their giant heeds, use a straight blade, look up, and you're home free.

So when the anesthesiologist brings in a wee laddie in a crib in traction, meaning their legs are up in the air, their chin is slouched into their chest, there's no way to approach them straight from above like we normally do, and then he says, "let's intubate him on the crib", and, "I normally don't use a paralytic", that's an awesome set up. Sterling. Perfect.

We ended up using a paralytic. Then I got it the second time. Gives me a lot of respect for paramedics intubating with less than ideal conditions, including in cars, in fields, and so on. However, when you have time, it seems silly to me not to use every advantage the first time, every time. Ironic, since usually the anesthesiologists call us cowboys, not the other way around.