Key Point
The Difficult Airway box is kept in the Neonatal Blood Gas Room (Wexham Park) and Difficult Airway Drawer on resus trolley (Frimley Park)
If an experienced clinician has had up to 2 intubation attempts but failed to intubate, or judges the airway to be a difficult airway, they should declare “this is a difficult airway situation with failed intubation” and proceed to activate this difficult neonatal airway algorithm.
Where a difficult airway has been encountered, the team should ensure that an alert is put on the baby’s medical records.
ETCO2 quantitative waveform monitoring is a mandatory standard of monitoring in anaesthetic practice for confirmation of ETT placement.
"Use the contact details in the flow chart below in an emergency.
However, if there are anticipated future airway concerns in a stable baby please liaise with anaesthetics/ENT to ensure they are aware of the baby. The agreed pathway to do this is:
Anaesthetic contact
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Contact the “starred” anaesthetic consultant/anaesthetic consultant on call between 08:00 and 18:00 via switchboard. They can review the patient and give an anaesthetic opinion.
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Out of hours contact the on call CEPOD/theatre anaesthetic resident to review the patient. (07768463877). The on-call anaesthetic consultant can always be contacted for a consultant-to-consultant discussion.
ENT contact
- Contact the ENT consultant through switchboard. MDT discussion (anaesthetics, ENT, paediatrics) may follow to make a final plan which can be circulated and recorded on Epic."
| Version: | 2.1 |
|---|---|
| Date Issued: | 11/112025 |
| Review Date: | 01/09/2028 |
| Key words: | Difficult airway, neonatal intubation |
This is a controlled document. If you are using a printed copy, check it against the guidelines site to ensure you are using the latest edition. Print copies must be destroyed after use.
Abbreviations
| PIP | Peak inspiratory pressure |
|---|---|
| PEEP | Peak end expiratory pressure |
| ETT | Endotracheal tube |
| FiO2 | Fraction of inspired oxygen |
| LMA | laryngeal mask airway |
| NPA | nasopharyngeal airway |
| ENT | Ear, Nose & Throat (team) |
| HFT | High Flow (Humidified Oxygen) Therapy |
| FONA | Front of neck airway |
| ETCO2 | End tidal carbon dioxide |
| MAST | Making the Airway Safe Trolley |
| IV/IO | Intravenous / intraosseous |
