Abstract：
BACKGROUND: Most airway problems in children are identified in advance; however, unanticipated difficulties can arise and may result in serious complications. Training for these sporadic events can be difficult. We identified the need for a structured guideline to improve clinical decision making in the acute situation and also to provide a guide for teaching.
OBJECTIVE: Guidelines for airway management in adults are widely used; however, none have been previously devised for national use in children. We aimed to develop guidelines for the management of the unanticipated difficult pediatric airway for use by anesthetists working in the nonspecialist pediatric setting.
METHODS: We reviewed available guidelines used in individual hospitals. We also reviewed research into airway management in children and graded papers for the level of evidence according to agreed criteria. A Delphi panel comprising 27 independent consultant anesthetists considered the steps of the acute airway management guidelines to reach consensus on the best interventions to use and the order in which to use them. If following the literature review and Delphi feedback, there was insufficient evidence or lack of consensus, regarding inclusion of a particular point; this was reviewed by a Second Specialist Group comprising 10 pediatric anesthetists.
RESULTS: Using the Delphi group\'s deliberations and feedback from the Second Specialist Group, we developed three guidelines for the acute airway management of children aged 1-8 years.
CONCLUSIONS: This paper provides the background, available evidence base, and justification for each step in the resultant guidelines and gives a rationale for their use.
OBJECTIVE: Guidelines for airway management in adults are widely used; however, none have been previously devised for national use in children. We aimed to develop guidelines for the management of the unanticipated difficult pediatric airway for use by anesthetists working in the nonspecialist pediatric setting.
METHODS: We reviewed available guidelines used in individual hospitals. We also reviewed research into airway management in children and graded papers for the level of evidence according to agreed criteria. A Delphi panel comprising 27 independent consultant anesthetists considered the steps of the acute airway management guidelines to reach consensus on the best interventions to use and the order in which to use them. If following the literature review and Delphi feedback, there was insufficient evidence or lack of consensus, regarding inclusion of a particular point; this was reviewed by a Second Specialist Group comprising 10 pediatric anesthetists.
RESULTS: Using the Delphi group\'s deliberations and feedback from the Second Specialist Group, we developed three guidelines for the acute airway management of children aged 1-8 years.
CONCLUSIONS: This paper provides the background, available evidence base, and justification for each step in the resultant guidelines and gives a rationale for their use.
摘要：
背景：儿童的大多数气道问题都是事先确定的；但是，可能会出现意想不到的困难，并可能导致严重的并发症。对这些零星事件的培训可能很困难。我们确定了需要一个结构化的指南来改善紧急情况下的临床决策，并为教学提供指导。
目的：成人气道管理指南被广泛使用；然而，以前没有设计供全国儿童使用。我们旨在制定指南，以管理意外的困难的儿科气道，供在非专科儿科环境中工作的麻醉师使用。
方法：我们回顾了个别医院使用的可用指南。我们还回顾了儿童气道管理的研究，并根据商定的标准对证据水平进行了分级。由27名独立顾问麻醉师组成的Delphi小组考虑了急性气道管理指南的步骤，以就使用的最佳干预措施和使用顺序达成共识。如果遵循文献综述和德尔菲反馈，证据不足或缺乏共识，关于纳入特定点;由10名儿科麻醉师组成的第二专家小组对此进行了审查。
结果：使用Delphi小组的审议和第二专家组的反馈，我们为1~8岁儿童的急性气道管理制定了三项指南.
结论：本文提供了背景，可用的证据基础，以及由此产生的指南中每个步骤的理由，并给出了使用它们的理由。
目的：成人气道管理指南被广泛使用；然而，以前没有设计供全国儿童使用。我们旨在制定指南，以管理意外的困难的儿科气道，供在非专科儿科环境中工作的麻醉师使用。
方法：我们回顾了个别医院使用的可用指南。我们还回顾了儿童气道管理的研究，并根据商定的标准对证据水平进行了分级。由27名独立顾问麻醉师组成的Delphi小组考虑了急性气道管理指南的步骤，以就使用的最佳干预措施和使用顺序达成共识。如果遵循文献综述和德尔菲反馈，证据不足或缺乏共识，关于纳入特定点;由10名儿科麻醉师组成的第二专家小组对此进行了审查。
结果：使用Delphi小组的审议和第二专家组的反馈，我们为1~8岁儿童的急性气道管理制定了三项指南.
结论：本文提供了背景，可用的证据基础，以及由此产生的指南中每个步骤的理由，并给出了使用它们的理由。
