You are the consultant in charge of a tertiary ED. A 2000h a 3-year-old, 15kg male child presents with his parents with reported large volume bleed 6 days post-tonsillectomy. The child is continuing to bleed actively and looks pale and unwell. Observations are as follows : GCS 15. HR 188, BP 85/65, RR 34, Sats 99%RA

1. State your immediate management priorities. 6 marks

The ENT surgeons are en route to hospital. Unfortunately, you are not able to stem the bleeding and the child is becoming more distressed. Observations are now : HR 160, BP 95/65, Sats 92%RA. You decide to proceed to intubation.

2. Describe your ideal technique for intubation including equipment sizes and drug doses. 6 marks