Assessment and management of the predicted difficult airway in babies and children

The situation when a child is unexpectedly difficult to manage with bag-and-mask ventilation is rare. Most difficult paediatric airways are predictable, so there is time for thought and preparation. This article outlines the anatomical differences present in the child and describes assessment of the paediatric airway. Equipment available for managing the predicted difficult airway in a child are reviewed. Emphasis is placed on planning, preparation and practice: the three Ps of the difficult paediatric airway.