Procedure

Laryngospasm Notch Maneuver

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Laryngospasm Notch Maneuver, Laryngospasm on Induction

  • Indications
  1. Laryngospasm (especially with Ketamine in children)
  • Mechanism
  1. Unclear (may be due to jaw-thrust motion or vagal nerve stimulation)
  • Technique
  1. Bilateral Landmarks
    1. Identify a notch posterior to Ear Pinna and anterior to mastoid process
    2. Pressure point will be at the very apex of the notch, as hig has possible along the posterior edge of Mandible ramus
  2. Maneuver
    1. Press on both sides, at the apex of each notch
    2. Push inward and anterior at each of the 2 notches
  3. Effect
    1. Laryngospasm typically improves within 1-2 breaths
  • Management
  • Alternative Measures for Laryngospasm with Consious Sedation or Induction
  1. See Ketamine
  2. Jaw Thrust Maneuver
  3. Two-handed bag-valve mask (BVM)
  4. Paralysis (Rocuronium or Succinylcholine) and intubation
  • Resources
  1. ALIEM: Laryngospasm Notch Maneuver (Lin, 2010)
    1. https://www.aliem.com/2010/trick-of-trade-laryngospasm-notch/