Title: Pediatric intubation
题目：小儿气管插管
Author 作者: Mimi Lu

When intubating an infant, a few key points need to be kept in mind:
当给一个婴儿插管时，需要注意如下几项：
Remember that the narrowest point is the cricoid, so even if the ETT passes the cords it might still not pass through the cricoid itself.
记住，气管最狭窄的部位是环状软骨，即使气管导管通过了声门，并不能保证通过环状软骨。
Remember premedication with atropine is recommended in all children less that 1 year old and in those less than 5 years old when using succinylcholine. It is used to prevent reflex bradycardia and high ICP and to decrease secretions. The dose is 0.02 mg/kg IV, with a minimum of 0.1 mg and a max of 0.5 mg. Give it 2 full minutes before the start of intubation.
记住，对1岁以内或5岁以内但要用琥珀胆碱的儿童插管前要给阿托品。主要是为了防止反射性心动过缓，增加颅压，和减少分泌物。平均剂量是0.02mg／kg静脉，最少0.1mg，到最大量0.5mg。要在插管前等2分钟。
Remember that succinylcholine is contraindicated in neuromuscular disease (including an undiagnosed myopathy). A slightly higher dose (2mg/kg) may need to be used in infants (compared to 1-1.5mg/kg in adults and older children).  
记住，琥珀胆碱在有神经肌肉疾病（包括诊断不明确的肌病）时是禁用的。婴儿的剂量（2mg／kg）要比大一点的孩子和成人（1－1.5mg／kg）高一点.
Pressure control mode is preferred over volume control (VC) setting in peds, because VC tends to overestimate how much volume it's delivering, therefore delivering inadequate ventilation.
由于容量控制型呼吸模式会高估输出容量，从而导致通气不足，因此首先要考虑应用压力控制型呼吸机模式。
Remember your alternatives: High Flow Nasal cannula (HFNC) can be used in infants with respiratory distress to avoid intubation. One study showed that is decreased intubation rates by 68% in respiratory distress due to bronchiolitis
要记住其它的选择：为避免气管插管，对呼吸困难的婴儿可使用高流量鼻导管给氧。有一个研究结果显示，此方法在治疗由细支气管炎导致的呼吸困难时可以减少68％的气管插管率。
 
References 参考文献:
1. Santillanes G, Gausche-Hill M. Pediatric Airway Management. Emerg Med Clin N Am 26 (2008) 961–975
2. Bledsoe G H, Schexnayder S M. Pediatric Rapid Sequence Intubation A Review. Ped Emerg Care 20 (2004) 339-344