Failure of intubation in acute inflammatory airway obstruction in childhood.

At the present time, viral laryngotracheobronchitis, (LTB), and bacterial epiglottitis account for the majority of cases of acute infectious upper airway obstruction in children. This airway obstruction may become life-threatening and require relief either by tracheotomy or by nasotracheal intubation. Recently the trend has been away from tracheotomy and towards intubation. Three cases are reported in this paper, in which intubation by experienced anaesthetists proved impossible, and a life-saving tracheotomy was immediately performed by the otolaryngologist in attendance. It is recommended that an experienced otolaryngologist should always be present at the time of intubation, should it prove impossible, and the child require emergency tracheotomy to secure the airway.