Verse 1 – First Assessment Assess respiratory rate, effort in the room, Oxygenation tells us what’s coming soon. Airway and breathing—adequate or not? That first decision is everything we’ve got. If adequate, oxygen flows light and clean, Saturation goal ninety-two is seen. We stabilize, monitor, move along, Exit to protocol when everything’s strong. ⸻ Chorus Tiny chest but the stakes run high, Every breath matters when we decide. Airway first in the pediatric fight, We hold them steady through the night. If oxygen drops, we don’t delay— We step in fast and guide the way. ⸻ Verse 2 – Ventilation Rhythm (BY AGE) When we bag, we don’t guess the pace, Age defines the ventilation rate we face. Neonate breaths at thirty per minute, Gentle pressure, rhythm in it. Toddler drops to twenty-five, Careful timing keeps them alive. School age slows to twenty each time, Controlled ventilation stays in line. Adolescent and up—adult-style flow, Ten to twelve per minute we go. Each breath measured, never too fast, Avoid hyperventilation that won’t last. ⸻ Verse 3 – When It’s Not Adequate If airway or breathing starts to fail, We follow the pediatric airway trail. Basic maneuvers come first in line— Chin lift, jaw thrust every time. Nasal or oral airway placed with care, BVM support to push in air. PEEP added if needed there, We stabilize respiratory despair. Spinal motion restriction if indicated case, AMS protocol if mental status changes face. We monitor, reassess, never lose sight, Keep oxygen flowing steady and right. ⸻ Pre-Chorus – Monitoring Constant Capnography tracing every breath, End-tidal CO₂ guiding us next. Mandatory monitoring, pediatric rule, Every waveform keeps us cool. If tracheostomy present, we adjust the flow, Respiratory distress protocols go. Notify destination or medical control, Communication is part of the goal. ⸻ Chorus Small airway, but the stress runs deep, We watch their breathing while others sleep. Oxygen first, support the chest, We do what pediatric airways demand best. From basic mask to advanced care, We adapt with precision everywhere. ⸻ Verse 4 – Escalation Pathway If obstruction blocks the airway tight, We run foreign body protocol right. Direct or video laryngoscopy may be used, Optional tools carefully chosen and fused. Orotracheal intubation enters the plan, Stylet used whenever we can. Depth and size we calculate fast, Three times tube diameter holds it fast. If attempt defined by blade through teeth, We reassess what lies beneath. If first attempt fails, we don’t repeat, We adjust equipment or provider seat. Three total attempts—no more allowed, Experienced hands must think it out loud. If ventilation fails and oxygen drops, We shift to pediatric failed airway stops. ⸻ Bridge – Failed Airway Definition Unable to ventilate or oxygenate well, Below ninety-two—this is the bell. Anatomy won’t allow continued try, Or three failures despite effort applied. We exit protocol, we change the fight, We prioritize oxygen over the sight. Call for backup if resources exist, We don’t let saturation persist. ⸻ Verse 5 – Rescue Techniques BVM with adjuncts stays in play, Maintain oxygen saturation each way. If needed, BIAD comes into view, A safer bridge when we’re overdue. Chest decompression if needed in case, Air trapping or tension space. NIPPV considered if child can tolerate flow, We adjust support as we go. Post-intubation or BIAD care begins, Secure the tube so nothing shifts within. Manual stabilization during every move, We protect the airway, we prove and improve. C-collar support even when unsure, Pediatric airway needs to endure. ⸻ Bridge – Critical Last Resort Cricothyrotomy needle only if dire, Life-saving measure when all else expires. Under twelve years—last resort rule, Evidence limited, but used as tool. Rare in practice but still defined, When every airway option is declined. ⸻ Chorus Small airway, massive demand, Every second controlled by hand. We oxygenate before we escalate, We stabilize before it’s too late. From neonate to adolescent light, We match ventilation to every life. From jaw thrust to advanced device, We balance science with every device. ⸻ Outro – DOPE Check Displacement, obstruction we must see, Pneumothorax or equipment failure be. Every airway we constantly scan, We correct issues as fast as we can. From first breath to controlled return, Each tiny patient gives us reason to learn. Small airway—but we stand prepared, With calm precision, skilled and aware.
