Kemper ME, et al. - Researchers investigated if a reduced incidence of hypoxaemia and difficult direct laryngoscopy, without increasing perioperative respiratory complications, can be achieved with bag mask ventilation between induction of anaesthesia and tracheal intubation in children with post-tonsillectomy bleeding. Participants were patients undergoing anaesthesia for surgical revision of bleeding tonsils. They noted the type of rapid sequence induction and intubation (RSII; classical, ie, apnoeic, vs controlled, ie, with gentle bag mask ventilation). Overall 22 children had 22 surgical revisions with a classical RSII performed, and 81 children with 88 surgical revisions using a controlled RSII. Less incidence of severe hypoxaemia, better direct-laryngoscopic views and less hypertension were observed in patients undergoing controlled RSII vs those managed by classical RSII, demonstrating benefits of controlled RSII over classical RSII in children with post-tonsillectomy bleeding. No pulmonary morbidity was reported in relation to the use of bag mask ventilation. To avoid hypoxaemia, difficult laryngoscopy and hypertension during induction of anaesthesia and tracheal intubation in these patients, controlled RSII may afford a strategic option.