We suggest quantitative monitoring of NMB in children with chronic use of anticonvulsants, as they may need higher doses or more frequent administration of aminosteroid NMBA to maintain NMB. (Conditional recommendation based on very low level of evidence)

As the administration of succinylcholine shortly after neostigmine can result in a prolonged duration of action, we suggest quantitative monitoring of NMB if succinylcholine is given after administration of neostigmine (see also Question 3 PICO4) If NMB is required less than 2 h after reversal of rocuronium with sugammadex, we suggest using a nonsteroidal NMBA or titrating the rocuronium dose based on quantitative monitoring to achieve sufficient NMB. (Conditional recommendation based on very low level of evidence)

Focused cardiac ultrasound should be performed in the following situations: ▪ Evaluation of the anatomy and function of the heart in emergency situations ▪ Acute hemodynamic instability ▪ Acute respiratory insufficiency with suspicion of a cardiac origin ▪ Resuscitation

Focused cardiac ultrasound should include the following sectional planes: ▪ Subcostal long axis view ▪ Subcostal view of the inferior vena cava ▪ Parasternal long axis view ▪ Parasternal short axis view on the mid-papillary plane ▪ Apical four-chamber view

The most important issues to be investigated by focused cardiac ultrasound are: ▪ Left- and right-ventricular size ▪ Position of the interventricular septum ▪ Global and regional ventricular function ▪ Intravasal volume status ▪ Position of the atrial septum ▪ Pericardial effusion and signs of tamponade ▪ Evidence of chronic cardiac insufficiency ▪Severe valve pathologies ▪ Cardiac mass (e.g., thrombi, vegetations caused by endocarditis)

If focused cardiac ultrasound does not provide sufficient visualization, another examiner should be consulted and/or another diagnostic method should be used.

Focused cardiac ultrasound is not a replacement for comprehensive echocardiography. If there is suspicion of cardiac disease, comprehensive echocardiography should be performed.Comprehensive echocardiography should be recommended in the focused cardiac ultrasound report.

In the case of unclear hemodynamic instability or acute impaired oxygenation, focused cardiac ultrasound as well as ultrasound examination of the lung (pleura and chest) and of the abdomen (FAST examination) should be performed.

HFNO or low‑ffow nasal oxygen can be beneffcial in increasing the time to desaturation in paediatric patients (1–12 years)

Videolaryngoscopy is not beneffcial in enhancing the success rate of intubation compared to direct laryngoscopy, despite improving the glottic view in children.