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You are called by the intensivist to urgently assist with airway management in the Paediatric Intensive Care Unit. A 1-year old girl presented earlier in the day with acute epiglottitis and was taken to theatre for intubation. Unfortunately, due to significant swelling, an endotracheal tube could not be passed and a tracheostomy was urgently placed by ENT. The patient was taken to ICU but now, six hours later, there is difficulty with ventilation. On your arrival the monitor shows the following:
Systolic blood pressure 62 mmHg
Heart rate 126 bpm
SpO2 72%
There is no end-tidal CO2 trace visible.
Outline your approach to managing this situation.
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