New technical devices and concepts for pediatric emergency medicine

New technical devices and concepts have been recently developed for pediatric emergency medicine. At the same time, practical approaches have been analysed using animal models or actual resuscutation outcomes. A "bone injection gun" can be used for the automatic placement of intraosseous venous access in children. While this may circumvent practical problems with the manual placement of such needles, its actual impact on clinical practice has not been analysed. Technical devices to check correct tube positioning after emergency intubation have become available. A special pediatric CO2-detection device with a color coded display appears to be the best variant, although checking the tube position with a laryngoscope, chest excursions, and breath sound remain the most important means to determine successful intubation. The American Heart Association recommends the use of automatic defibrillators in children >8 years, because the occurrence of treatable rhythm disturbances during resuscitation have been recognised in this age group. The currently available automatized defibrillators deliver a minimal energy of 100 (200) J, while 1-2 J/kg are recommended in children. The Pediatric Working Group of the Liaision Committee on Resuscitation currently does not reommend the use of high-dose adrenalin in pediatric resuscitation,the use of air during the resuscitation of newborns or the laryngeal mask airway instead of endotracheal intubation, as the data base for these newer concepts appears insufficient at present.