Difficulty during intubation in the pediatric emergency department of a tertiary care childrens hospital

: Emergency department intubation (EDI) is frequently the primary lifesaving intervention in the management of critically ill children. RSI (rapid sequence intubation) is the method of choice for intubation in ED. But it requires enormous expertise and training, but this is not feasible always in a resource limited setting like ours. So modified RSI and facilitated intubation are practiced in many EDs. This study was done over a period of two months in a tertiary care pediatric emergency department to identify the difficulties arising during intubation using non RSI protocol (modified RSI,facilitated intubation) compared to that of RSI. 68 children were intubated by the modified RSIfacilitated intubation during the study period.54.4 percentage (n-37) of the intubated children were below the age group of 1 year. 91.1 percentage (n-62) of the children were intubated on the first attempt. The difficulties encountered during intubation of these 68 children were difficult intubation8.9 percentage (n-6), failure to visualize glottis 5.9 percentage (n-4), airway bleeding 4.4 percentage (n-3). Both Modified RSI and facilitated intubation appeared to be practically feasible and safe methods for intubation in critically ill children without much difficulty compared to RSI.