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June 2017

The 10 Commandments of Management for Acute Upper Airway Obstruction in Infants and Children

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2017;143(6):539-540. doi:10.1001/jamaoto.2017.0219

The only source of knowledge is experience.

Albert Einstein

In a prior era when epiglottitis and diphtheria were prevalent and before there were required warnings on the packaging of choking hazard objects, otolaryngologists were facile with the management of acute upper airway obstruction (AUAO) in children, but nowadays the management of AUAO in the pediatric patient can be frightening for an otolaryngologist. The 10 commandments that follow are based largely on experience with management of AUAO by the senior author (K.M.G) and one of the coauthors (J.L.), a young pediatric otolaryngologist, along with input from the other coauthor, a resident in otolaryngology (L.F.I). These commandments are offered as practical suggestions or hints to avoid treacherous pitfalls for those who accept the daunting responsibility of managing pediatric AUAO. They are not intended to be concrete, inviolate rules but instead are meant to provide succinct hints that should be used as an adjunct to methodical decision making with vigilant attention to detail.