carotid massage

Carotid massage

Carotid massage: Carotid massage can release chemicals to slow the heart rate. Carotid massage is generally limited to young, healthy people because older people are at risk for stroke. In the emergency department, the patient will be connected to a heart monitor because the decrease in heart rate can be dramatic. Carotid massage involves gently pressing and rubbing the carotid artery located in the neck just under the angle of the jaw. 

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Funnel or tapered shaped pediatric airway

Pediatric airway, especially for those 2 years of age, has often been described as a funnel-shaped with its narrowest part at the level of the cricoid cartilage (in contrast with the cylindrical adult larynx).

But where does this concept originate from?

Ríos Medina et al (2012) in a review article stated that it was way back in 1951 when Eckenhoff wrote about the anatomical considerations of the pediatric larynx and their implications for anesthesia.

However, Eckenhoff’s article was in turn based on descriptions made half a century before by Bayeux, who reported the findings from anatomic dissections in 15 bodies of children between 4 months and 14 years of age, together with their corresponding plaster models. In that article, Eckenhoff describes the cricoid cartilage as a rigid structure that cannot be distended in order to pass the ETT, and describes how its parts come together to form a ring around the larynx. Eckenhoff actually clearly states the danger of extrapolating such cadaver findings to live human beings. Unfortunately a number of anesthesiology textbooks picked up on these anatomical descriptions of the pediatric airway since then.
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