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Evidence Repository

Pediatric Respiratory Distress

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EVIDENCE REPOSITORIES

This evidence repository is a collection of best available resources and evidence collated by a knowledge synthesis team at Alberta Research for Health Evidence (ARCHE) and the clinical content team.

The knowledge synthesis team utilizes a pyramid-shaped framework, built upon the “4S” hierarchy of evidence model, to provide detailed evidence appropriate to meet stakeholders’ needs. They search a combination of databases (Cochrane Library, PubMed, TRIP Database) and web-based search engines (Google, Google Scholar) to locate evidence for the knowledge pyramids. Publication types sought in the initial topic searches are organized into five levels that determine the order in which resources are presented:

  1. Bottom Line Recommendations
  2. Clinical Practice Guidelines and Pathways
  3. Overviews and Summaries of Systematic Reviews
  4. Systematic Reviews
  5. Key Studies

Where applicable resources for families and parents are also listed.

The knowledge synthesis team collaborates with the clinical content team to select the most relevant guidelines, reviews, and key studies, which can be found below. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription).

More information about the creation of our evidence repositories can be found here.

Content Team

Thank you to the following clinical content experts and Knowledge Synthesis team who led the development of this evidence repository.

Dominic Allain, MD, FRCPC, Director, Global Health Program and Associate Clinical Professor, Department of Pediatrics, University of Alberta

Katherine Falla, MD, University of Manitoba

Martha Balicki, MSc, MD, Health Sciences Centre, Winnipeg, Manitoba

Liza Bialy, BSc, MPH, Knowledge Synthesis Project Coordinator, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta

Sarah Elliott, PhD, Assistant Director, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta

TREKK developed resources for healthcare providers and parents & families can be found here.

Overviews And Summaries Of Systematic Reviews

  1. White JJ, Cambron JD, Gottlieb M, Long B. Evaluation and management of airway foreign bodies in the emergency department setting. J Emerg Med. 2023;64(2):145-55.
  2. Miller KA, Goldman MP, Nagler J. Management of the difficult airway. Pediatr Emerg Care. 2023;39(3):192-200.
  3. Kanaris C, Murphy PC. Fifteen-minute consultation: Intubation of the critically ill child presenting to the emergency department. Arch Dis Child Educ Pract Ed. 2022;107(5):330-7.
  4. Challands J, Brooks K. Paediatric respiratory distress. BJA Educ. 2019;19(11):350-6.
  5. Agbim CA WN, Lee M. Respiratory distress in pediatric patients. Relias Media. 2018.
  6. Schibler A, Franklin D. Respiratory support for children in the emergency department. J Paediatr Child Health. 2016;52(2):192-6.
  7. Rodríguez H, Passali GC, Gregori D, et al. Management of foreign bodies in the airway and oesophagus. Int J Pediatr Otorhinolaryngol. 2012;76 Suppl 1:S84-91.
  8. Al-Mutairi B, Kirk V. Bacterial tracheitis in children: Approach to diagnosis and treatment. Paediatr Child Health. 2004;9(1):25-30.

Systematic Reviews

  1. Weihing VK, Crowe EH, Wang HE, Ugalde IT. Prehospital airway management in the pediatric patient: A systematic review. Acad Emerg Med. 2022;29(6):765-71.
  2. Morrison JM, Hassan A, Kysh L, et al. Diagnosis, management, and outcomes of pediatric tracheostomy-associated infections: A scoping review. Pediatr Pulmonol. 2022;57(5):1145-56.
  3. Lecky F, Bryden D, Little R, et al. Emergency intubation for acutely ill and injured patients. Cochrane Database Syst Rev. 2008;2008(2):Cd001429.

Key Studies

  1. Ramgopal S, Belanger T, Lorenz D, et al. Preferences for Management of Pediatric Pneumonia: A Clinician Survey of Artificially Generated Patient Cases. Pediatr Emerg Care. 2024 Jul 1.
  2. Hannah R, Chavasse RJPG, Paton JY, Walton E, Roland D, Foster S, Lyttle MD; PERUKI. Emergency department discharge practices for children with acute wheeze and asthma: a survey of discharge practice and review of safety netting instructions in the UK and Ireland. Arch Dis Child. 2024 Jun 19;109(7):536-542.
  3. VanDeWall A, Harris-Kober S, Farooqi A, Kannikeswaran N. Peri-intubation arrest in high risk vs. Standard risk pediatric trauma patients undergoing endotracheal intubation. Am J Emerg Med. 2023;67:79-83.
  4. Jose D, Parameswaran N. Advances in management of respiratory failure in children. Indian J Pediatr. 2023;90(5):470-80.
  5. Giorno EPC, Foronda FK, De Paulis M, et al. Point-of-care lung ultrasound score for predicting escalated care in children with respiratory distress. Am J Emerg Med. 2023;68:112-8..
  6. Castro D, Freeman LA. Oropharyngeal airway. Statpearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2023, StatPearls Publishing LLC.; 2023.
  7. Skirko J. Childhood respiratory conditions: Stridor. FP Essent. 2022;513:25-31.
  8. Pacheco GS, Patanwala AE, Leetch AN, et al. Intubation during pediatric cardiac arrest in the emergency department is associated with reduced first-pass success. Pediatr Emerg Care. 2022;38(5):e1271-e6.
  9. Moslehi MA. Failures in emergency management of pediatric airway foreign bodies by rigid bronchoscopy: We have yet to complete our learning. World J Pediatr Surg. 2022;5(2):e000321.
  10. McCans K, Varma S, Ramgopal S, et al. Variation in prehospital protocols for pediatric respiratory distress management in the United States. Pediatr Emerg Care. 2022;38(7):e1355-e61.
  11. Kovacich NJ, Nelson AC, McCormick T, Kaucher KA. Incidence of bradycardia and the use of atropine in pediatric rapid sequence intubation in the emergency department. Pediatr Emerg Care. 2022;38(2):e540-e3.
  12. Hagiwara Y, Goto T, Ohnishi S, et al. Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study. Acute Med Surg. 2022;9(1):e798.
  13. Gayen GC, Das D, Ray R, Maitra M. Management of tracheo-bronchial foreign bodies in children: Our experience. Indian J Otolaryngol Head Neck Surg. 2022;74(4):536-9.
  14. Demir Ş, Anıl M, Yalçın G, et al. Early predictors of high-flow nasal cannula oxygen treatment failure in patients with respiratory distress admitted to the pediatric emergency department. Turk J Pediatr. 2022;64(4):648-57.
  15. D’Addio E, Palma PL, Di Sessa A, et al. Foreign body aspiration in children-diagnostic clues through a clinical case. Pediatr Rep. 2022;14(1):81-5.
  16. Capone CA, Emerson B, Sweberg T, et al. Intubation practice and outcomes among pediatric emergency departments: A report from national emergency airway registry for children (near4kids). Acad Emerg Med. 2022;29(4):406-14.
  17. Apuy M, Yock-Corrales A, Moreno AM, Gutierrez A. Streptococcus pyogenes epiglottitis in a child: A case report. Cureus. 2022;14(4):e24123.
  18. Nayani K, Naeem R, Munir O, et al. The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department. BMC Pediatr. 2018;18(1):339.
  19. Dieckmann RA, Brownstein D, Gausche-Hill M. The pediatric assessment triangle: A novel approach for the rapid evaluation of children. Pediatr Emerg Care. 2010;26(4):312-5.

Other Resources

  1. United Medical Education. PALS algorithm. 2023.
  2. Helman AF, J. Ivankovic, M. Kovacs, G. Burn and inhalation injuries: ED wound care, resuscitation and airway management. Emergency Medicine Cases. 2019.
  3. Helman AF. Pediatric respiratory failure (podcast). Emergency Medicine Cases. 2019.
  4. PedsCases: Pediatric Education Online. Pediatric vital signs reference chart. 2018.