2. Anatomic and Physiologic Considerations of the Pediatric Airway:. 3. Initial Assessment:. Signs of impending respiratory failure:Reduced level of consciousness or lethargyQuiet, shallow breathingApneaThe above require immediate progression to endoscopy and/or intubation.. 4. History:. Description of OnsetAge at onsetHistory of foreign body aspiration/ingestionAggravating factors: feeding/sleepingHistory of intubationBirth history (syndromes, birth trauma).