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The expected difficult airway in children is a rare but challenging entity. Publications about pediatric airway management present global recommendations and strategies in order to improve safety and outcome. However, even when a careful plan is implemented according to these fundamental aspects, safety and efficacy may be compromised. The presence of another anesthesiologist with expertise in pediatric difficult airway approach, exhaustive description of previous airway approaches and the meticulous revision of the available material including that for invasive procedures should always be kept in mind.
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