Is endotracheal intubation the only way to manage the airway when a child is in respiratory distress?
No. In fact, bag-valve-mask ventilation is adequate for many children with transient, reversible airway problems. Positioning the child with some extension of the neck and moving the mandible forward by lifting the angles of the jaw pulls the tongue off the posterior pharynx, often relieving airway obstruction. Oral airways (for unconscious patients) and nasal airways can be used to maintain the patency of the upper airway during bag-valve-mask ventilation. Provide to all children effective bag-valve-mask ventilation with 100% oxygen prior to intubation.
American Heart Association: 2010 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 14: Pediatric Advanced Life Support. Circulation 2010;122(18):878.