Certified in the Esmarch Maneuver, Defeated by Toddler Tantrums

They trained me to secure airways under fire,
to bag trauma patients blindfolded,
to drop an Esmarch maneuver faster than a crashing heart rate.

I can navigate a mass casualty drill without flinching.
I can run a code blue without blinking.

But none of that — none of it — prepared me
for the day a 20 kg force of rage,
armed with four sharpened canines and a juice box,
decided to wage total psychological warfare in my own living room.

Turns out, all the advanced airway management training —
even mastering the Esmarch maneuver —
is useless against an opponent who’s still figuring out how to spell “no.”

Some people survive medical school.
Others survive toddlers.
Very few survive both without at least one psychological airway compromise.

This is not a heroic story.
This is a cautionary tale of reflexes, bad life choices, and why having children should probably come with PPE and informed consent.

When Instinct Takes Over: Jaw Thrust vs Toddler Rage

It started innocently enough — like most traumas do.
She wanted something. I can’t even remember what anymore.
Juice? Stickers? My soul?

Whatever it was, I said no.
Gently, at first.
Because parenting books recommend setting boundaries calmly.
Because I believed, foolishly, that reason could prevail.

She asked again.
This time with more urgency.
A high-pitched sound only toddlers and malfunctioning smoke detectors can produce.

I said no again.
Maybe firmer.
Maybe slightly less convincing, because deep down I could feel it —
the atmospheric pressure dropping.

The third time, she didn’t ask.
She screamed.
The kind of scream that makes you instinctively glance around for an airway cart and call for back-up.

Before I could even form another rational thought,
she lunged — teeth bared, primal, deranged.

Suddenly, I wasn’t the parent anymore.
I was the unfortunate lead in Jaws: Pediatric Edition.

Instincts screamed useless airway protocols —
Head tilt! Jaw thrust! Bag her! —
before reality crashed back:
this wasn’t some obtunded trauma patient.
This was a two-foot-tall velociraptor,
armed with molars sharp enough to fracture metacarpals and absolutely no regard for guidelines.

Esmarch himself would have surveyed the scene, sighed, and called it.
Time of death: my dignity.
Suggested management: a glass of wine, a tetanus booster, and maybe never saying “no” to a toddler again without a helmet.

The Calm Before the Second Storm

For one delirious moment,
as her teeth sank somewhere between my dignity and my metacarpals,
my brain short-circuited.

In the collapsing wreckage of my mind,
I pictured a full trauma team crashing into my living room.
Backboard.
Cervical collar.
Esmarch maneuver at the ready.

Maybe even the honor of being ambulance’d out,
sirens screaming,
while a paramedic charted “mechanism of injury: small feral human.”

Reality — and a second wave of toddler rage — snapped me back fast.

There would be no Esmarch maneuver.
No trauma bay.
Just me, still upright, still unairwayed,
still holding the line against an opponent with zero regard for protocol or Geneva Conventions.

Somewhere between the stabbing pain and the phantom sirens wailing in my skull,
I let out a sound — not quite a scream, not quite a curse —
something primal enough to register on seismic monitors.

It was loud enough to snap her out of it.

And like any seasoned clinician, I froze.
Because if toddler tantrums have taught me anything, it’s that unexpected silence is never a blessing.
It’s a loading screen.

Three seconds.
That’s all the universe granted me.

Three seconds of confused, betrayed, juice-stained toddler eyeballing me like I had committed a war crime.
And then,
without warning,
the second wave hit.

Screaming, flailing, biting, kicking —
a full-scale toddler code blue,
no backup, no airway cart, no chance in hell.

This time, there was no Esmarch maneuver to save me.
Only chaos, clinical regret, and the creeping realization that toddlers possess rage reserves previously undocumented in any known medical literature.

Negotiating a Ceasefire: Lessons from Failed De-Escalation Protocols

By the second wave of screaming and unprovoked biting,
I realized I was wildly underprepared.
This wasn’t simple airway management anymore.
This was a full-blown Code Tantrum.

I attempted crisis de-escalation using every empowered parenting strategy I knew:

Therapeutic Communication (failed)

Nonviolent Crisis Intervention (laughed at)

Distraction Techniques (backfired and escalated to attempted strangulation with a juice box straw)

When that didn’t work, I escalated my response per trauma protocol:

• Primary Survey: ABCs (Airway, Biting, Containment)

• Secondary Survey: Emotional Damage Assessment

• Rapid Intervention: Deployment of Emergency Fruit Snacks

All attempts failed.

Turns out, toddlers are immune to traditional airway rescue algorithms once their rage-induced cortisol surge reaches irreversible levels.
No Glasgow Coma Scale.
No responsiveness.
Just pure, unfiltered pediatric wrath.

At that point, the only realistic options were:

1. Pray for spontaneous return of normal sinus rhythm,
2. Attempt extrication,
3. Update next-of-kin.

---

Acceptance: The Final Stage of Parental Trauma

At some point,
somewhere between your last drop of patience and your first whisper of existential despair,
the realization hits.

You are not running a resuscitation.
You are surviving a prolonged field combat situation.
And you are hopelessly outnumbered.

You abandon advanced airway protocols.
You triage your own dignity.
You apply psychological hemorrhage control techniques,
hoping to contain emotional blood loss to non-lethal levels.

At some point,
the toddler stops being a child entirely.
She becomes a one-person natural disaster —
small, volatile, and beyond any hope of containment.

No rapid sequence intubation.
No bag-valve-mask salvation.
Just shrieking, kicking, biting — and your slow internal acceptance that no amount of trauma training prepares you for unrestricted pediatric rage.

Because in the end, parenting isn’t about restoring vital signs.
It’s about surviving emotional blunt force trauma
and walking away with enough sarcasm intact to someday write the after-action report.

Battlefield Lessons from Unwilling Pediatrics

Surviving a toddler attack isn’t about strength.
It’s about strategy.
And a deep willingness to abandon your pride faster than an unsecured IV line during a code.

Here’s what I learned from the assault:

---

1. Always Watch the Hands
   If they clench into fists, you’ve got maybe three seconds before full-blown airway compromise.
   Treat it like you would a crashing airway:
   Move fast, don’t hesitate, and whatever you do — don’t lose eye contact.

---

2. Maintain Situational Awareness
   Never let your guard down.
   One minute they’re patting your face lovingly,
   the next they’re going for your jugular like a caffeinated ferret in Crocs.

---

3. Know Your Escape Routes
   Before saying “no,” mentally map your exit points.
   Bathrooms, laundry rooms, underneath the couch if necessary.
   You are not above hiding.
   You are a trauma professional. Act like it.

---

4. No Witnesses, No Shame
   If no other adults see you lose to a toddler,
   did it really happen?
   Exactly.

---

5. Always Have Backup
   Partner with a larger adult whenever possible.
   Preferably one who can perform a rapid sedation protocol involving fruit snacks, screen time, and desperate bargaining.

Parenting, it turns out, is just critical care
with worse staffing ratios, smaller patients, and even fewer success stories.

---

Some battles are loud.
Some battles are silent.
And some — like remembering the Esmarch maneuver while fending off a furious toddler —
are fought in that absurd gray zone between survival and surrender.

There are no medals awarded for surviving domestic warfare.
No codes called.
No chart notes written.

Only a silent, invisible scar —
stitched deep into your bones —
where dignity and battlefield exhaustion finally shook hands.

The Unspoken Code of Parenthood Trauma

The next morning, I limped into work covered in low-grade battlefield injuries:
tiny bite marks tracking my forearm,
a hairline scratch behind my ear,
a bruised hand that throbbed with every failed attempt to lift a coffee cup.

Nobody asked for a full history.
Nobody needed one.

The ICU crowd would recognize it instantly —
the unspoken aftermath of domestic warfare,
where even the best airway skills mean nothing,
and survival depends entirely on outrunning a toddler fueled by rage and four tiny canines sharpened by juice-box sugar.

A few colleagues raised eyebrows.
One silently slid a coffee toward me like a battlefield offering.
Another gave a slow nod, the universal signal for, “No need to explain. We’ve seen worse. Probably.”

I thought about explaining.
Maybe blaming it on a confused intoxicated patient, or an unfortunate slip on wet hospital floors.

But in the end,
I just smiled through the swelling,
sipped the coffee through a bruised grimace,
and said nothing.

Because those who know, know:
Sometimes survival isn’t heroic.
Sometimes survival just means fantasizing about an Esmarch maneuver —
not to save an airway,
but to claw your sanity free from a tantrum you never even saw coming.

No debriefing.
No chart notes.
No apologies.

Just the unspoken code:

“Patient survived. Provider… barely.”

Still Smell the Code? Good. You Belong Here.

If you’ve ever sweated through your scrubs,
braced for a crash airway,
and felt your hands move automatically — Esmarch maneuver, bag in place, no backup coming —
this is your people.

Drop your battlefield story below.
The close calls.
The saves nobody saw.
The ones that still wake you up at 3 a.m.

No judgment.
No debriefs.
No “you did everything you could” speeches.

Just scars, sarcasm, and the kind of dark humor that keeps hands steady when hearts break.

Welcome to PropofLOL.
Where airway legends are made,
and laughter is the last line of defense.