Supraglottic Airway Device Use During Paediatric Airway Management in the Emergency Department: A Registry Study

Sarah Rathe¹, Hatem Alkhouri^{2

3}, Katie Reeves⁴, Andrew Tagg⁵, Bernard McCarthy⁶, Sharon O'Brien^{6

7}, Eleanor Loughhead⁸, Ben Lawton⁹, Jeremy Furyk¹⁰, Frances B Kinnear¹¹, Matthew O'Gorman¹², Eunicia Tan^{13

14}, Andrew Brainard^{13

14}, Shane George^{15

16

17}, Amit Kochar^{17

18}, Simon Craig^{19

20

21}, Stefano Sabato^{19

22}, Franz E Babl^{1

19

23

24}, Elliot Long^{1

19

23

24}

Affiliations

¹ Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia.
² Agency for Clinical Innovation, Emergency Care Institute, Sydney, New South Wales, Australia.
³ Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
⁴ Department of Emergency Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.
⁵ Department of Emergency Medicine, Sunshine Hospital, Saint Albans, Victoria, Australia.
⁶ Department of Emergency Medicine, Perth Children's Hospital, Nedlands, Western Australia, Australia.
⁷ Division of Emergency Medicine, Anaesthesia & Pain Medicine, University of Western Australia, Perth, Australia.
⁸ Department of Emergency Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
⁹ Department of Emergency Medicine, Logan Hospital, Loganholme, Queensland, Australia.
¹⁰ Department of Emergency Medicine, University Hospital Geelong, Geelong, Victoria, Australia.
¹¹ Bundaberg Regional Clinical School, Rural Clinical School, Faculty of Medicine, University of Queensland, Bundaberg, Australia.
¹² Department of Emergency Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
¹³ Department of Emergency Medicine, Kidz First Middlemore Hospital, Auckland, New Zealand.
¹⁴ Department of Surgery, The University of Auckland, Auckland, New Zealand.
¹⁵ Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland, Australia.
¹⁶ School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
¹⁷ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
¹⁸ Department of Emergency Medicine, Women and Children's Hospital, Adelaide, South Australia, Australia.
¹⁹ Department of Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
²⁰ Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
²¹ Department of Emergency Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
²² Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Parkville, Victoria, Australia.
²³ Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
²⁴ Department of Critical Care, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 40390188
DOI: 10.1111/1742-6723.70056

Observational Study

Supraglottic Airway Device Use During Paediatric Airway Management in the Emergency Department: A Registry Study

Sarah Rathe et al. Emerg Med Australas. 2025 Jun.

. 2025 Jun;37(3):e70056.

doi: 10.1111/1742-6723.70056.

Authors

Affiliations

¹ Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia.
² Agency for Clinical Innovation, Emergency Care Institute, Sydney, New South Wales, Australia.
³ Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
⁴ Department of Emergency Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.
⁵ Department of Emergency Medicine, Sunshine Hospital, Saint Albans, Victoria, Australia.
⁶ Department of Emergency Medicine, Perth Children's Hospital, Nedlands, Western Australia, Australia.
⁷ Division of Emergency Medicine, Anaesthesia & Pain Medicine, University of Western Australia, Perth, Australia.
⁸ Department of Emergency Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
⁹ Department of Emergency Medicine, Logan Hospital, Loganholme, Queensland, Australia.
¹⁰ Department of Emergency Medicine, University Hospital Geelong, Geelong, Victoria, Australia.
¹¹ Bundaberg Regional Clinical School, Rural Clinical School, Faculty of Medicine, University of Queensland, Bundaberg, Australia.
¹² Department of Emergency Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
¹³ Department of Emergency Medicine, Kidz First Middlemore Hospital, Auckland, New Zealand.
¹⁴ Department of Surgery, The University of Auckland, Auckland, New Zealand.
¹⁵ Department of Emergency Medicine, Gold Coast University Hospital, Southport, Queensland, Australia.
¹⁶ School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
¹⁷ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
¹⁸ Department of Emergency Medicine, Women and Children's Hospital, Adelaide, South Australia, Australia.
¹⁹ Department of Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
²⁰ Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
²¹ Department of Emergency Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
²² Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Parkville, Victoria, Australia.
²³ Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
²⁴ Department of Critical Care, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 40390188
DOI: 10.1111/1742-6723.70056

Abstract

Background: Supraglottic airway devices (SGAs) are used in airway management to provide non-invasive ventilation and oxygenation. SGAs can be used as rescue tools in failed endotracheal intubation, difficult bag-mask ventilation, or as a bridge to intubation in cardiac arrest.

Objectives: The aim of this study was to describe the frequency of SGA use in children in emergency departments (EDs) across Australia and New Zealand and indications for their use.

Methods: We conducted a retrospective observational study using paediatric data from the Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) to describe the frequency of SGA use in children aged 0-18 years at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites over an 11-year period. Additionally, we surveyed 20 PREDICT sites to identify which SGA were used and describe their positions in their emergency airway management protocols and received 11 responses.

Results: SGAs were used during 14 out of 403 paediatric intubations (3.5%) across 12 PREDICT sites. The overall first pass success rate for intubation was 81.05% (325/401). SGAs were used prior to intubation in 14 cases, and as a rescue device following unsuccessful intubation in one case. Among the surveyed PREDICT EDs, 8 out of 11 (72%) reported having a difficult airway plan that included SGAs as a rescue device following unsuccessful intubation.

Conclusions: SGAs were used infrequently during emergency airway management outside of the operating room. SGA use as a rescue device following unsuccessful intubation was rare, despite their inclusion in most departments' difficult airway plan.

Trial registration: Australia and New Zealand Clinical Trials Registry: ACTRN12613001052729.

Keywords: SGA; children; paediatric emergency medicine; rescue device; supraglottic airway.

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References

1. J. E. Sanders and L. A. Spina, “Supraglottic Airway Devices for Pediatric Airway Management in the Emergency Department,” Pediatric Emergency Medicine Practice 17, no. 10 (2020): 1–20.
1. Brain AI, “The Development of the Laryngeal Mask—A Brief History of the Invention, Early Clinical Studies and Experimental Work From Which the Laryngeal Mask Evolved,” European Journal of Anaesthesiology. Supplement 4 (1991): 5–17.
1. E. J. Lavonas, S. Ohshimo, K. Nation, et al., “Advanced Airway Interventions for Paediatric Cardiac Arrest: A Systematic Review and Meta‐Analysis,” Resuscitation 138 (2019): 114–128.
1. R. Goyal, “Small Is the New Big: An Overview of Newer Supraglottic Airways for Children,” Journal of Anaesthesiology Clinical Pharmacology 31, no. 4 (2015): 440–449.
1. J. R. Benger, K. Kirby, S. Black, et al., “Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out‐Of‐Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS‐2 Randomized Clinical Trial,” Journal of the American Medical Association 320, no. 8 (2018): 779–791.

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Supraglottic Airway Device Use During Paediatric Airway Management in the Emergency Department: A Registry Study

Affiliations

Supraglottic Airway Device Use During Paediatric Airway Management in the Emergency Department: A Registry Study

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources