Clinical-use limit: Educational resource and cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.
Before intubation
- Use measured/length-based weight; consult pediatric ICU/ED leadership early.
- Correct resuscitation priorities and anticipate high minute ventilation demand.
- Prepare age-appropriate equipment, tube sizes, and post-intubation ventilator strategy before meds.
During intubation
- Minimize apnea and avoid under-ventilation immediately after paralysis.
- Use skilled first attempt and gentle ventilation.
- Avoid hypotension and hypoxia.
After intubation
- Set ventilation intentionally and recheck blood gas/EtCO2.
- Continue pediatric DKA protocol and cerebral edema vigilance.
- Reassess tube depth after transport and movement.
Common pitfalls
- Adult assumptions for equipment/dosing.
- Routine low minute ventilation after tube.
- Delayed peds/ICU consultation.