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Mechanical Ventilation of Pediatric Patients in the Emergency Department
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Pediatric patients have higher resistance due to narrower airways, as well as high chest-wall compliance. A more pliable chest wall results in lower functional residual capacity.
Use a cuffed endotracheal tube in all children.
Clinicians should use the mode of ventilation that is most familiar to them; the choice should be based on clinician experience, patient pathophysiology, and ventilator availability.
Use synchronized intermittent mandatory ventilation (SIMV) for patients without spontaneous respiratory effort, and use SIMV with pressure support for patients with spontaneous respiratory effort.
Use assist-control ventilation in patients with little to no spontaneous respiratory effort or in those who require complete respiratory support, as the ventilator will assume full work of breathing