an overview of paediatric anaesthesia
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An Overview of Paediatric Anaesthesia. Dr Anna Englin Paediatric Anaesthetist, MMC. Overview. Equipment/room set up Crises we see in kids. Equipment. A irway B reathing C irculation D rugs E nvironment/ exposure. Anaesthesia checklist. A irway B reathing C irculation D rugs

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an overview of paediatric anaesthesia

An Overview of Paediatric Anaesthesia

Dr Anna Englin

Paediatric Anaesthetist, MMC

overview
Overview
  • Equipment/room set up
  • Crises we see in kids
equipment
Equipment
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • Environment/ exposure
anaesthesia checklist
Anaesthesia checklist
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • Environment/ exposure
airway
Airway
  • Infants and neonates have anatomical differences cf adults
  • Different sized equipment
airways
Airways
  • Lift tongue and epiglottis away from upper airway
  • Different sizes: measure from centre of incisors to angle of jaw
  • Nasopharyngeal airways
lma s
LMA’s
  • Don’t forget in a difficult intubation!
  • Less reliable than in adults
intubation
Intubation
  • laryngoscopes
ett size
ETT size
  • ETT size = 4 +age/4
  • Cuffed vs uncuffed
equipment1
Equipment
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • Environment/ exposure
breathing
Breathing
  • T piece vs closed circuit
  • Paediatric breathing circuit
equipment2
Equipment
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • Environment/ exposure
circulation
Circulation
  • ECG sometimes not used, mainly useful to detect bradycardia
  • Blood pressure lower
  • Arterial line setup is different
equipment3
Equipment
  • Airway
  • Breathing
  • Circulation
  • Drugs
  • Environment/ exposure
exposure
Exposure
  • Neonates especially prone to hypothermia
  • Prevention of hypothermia
    • Operating theatre
    • Patient covering esp head
    • Warming blankets/ overhead heaters
    • Fluid warmers
    • Monitoring
laryngospasm
Laryngospasm
  • Common and can be scary!
  • Risk factors
    • Active or recent URTI
    • Reactive airways
    • Airway surgery
    • Stimulation during light anaesthesia
treatment of laryngospasm
Treatment of laryngospasm
  • CPAP with 100%O2
  • Propofol
  • Lignocaine: topical or IV 2mg/kg
  • Sux: 2mg/kg IV or 4mg/kg IM
bradycardia
Bradycardia
  • Risk factors
    • Cardiac disease
    • Hypoxia
    • Drugs esp sux
    • CVP insertion
    • Reflex eg oculo-cardiac reflex
  • Treatment
    • Treat cause
    • Atropine: 20mcg/kg IV or IM
  • Chest compressions if persistent
the end
The end

NB: no children were harmed in the making of this talk

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