The tissues of the oral pharynx are soft and very vascularized. This makes them more susceptible to trauma and excessive bleeding during injury or airway intervention.

Children have a large tongue relative to the oral cavity. As a result, the tongue is the most common cause of airway obstruction in an obtunded child. This may necessitate better head positioning or use of an airway adjunct.

Infants up to 6 months of age preferentially breathe through their noses and nasal obstruction can lead to respiratory distress.

The epiglottis is floppy and omega shaped. During intubation, it is often necessary to displace the epiglottis.

The larynx in children is located more superior and anterior than in adults. As the child grows, the larynx migrates inferiorly. In infants,it sits at the level of C1 to C2, whereas in adolescents and adults, it is at C4 to C5. The combination of a more superior and anterior laryngeal position makes it more difficult to align airway axes for direct laryngoscopy, making appropriate airway positioning crucial.

The cricoid ring is the narrowest portion of the airway, creating a funnel-like shape. The use of uncuffed endotracheal tubes helps prevent complications such as stenosis and is recommended in children under 9 years of age. Needle cricothyrotomy is recommended for those under 12 years old.

Due to a shorter tacheal length, providers should take care to avoid mainstem bronchus intubation. Children have narrow airways, making them susceptible to partial or complete obstruction due to edema or hemorrhage.