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An Overview of Paediatric Anaesthesia

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

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  1. An Overview of Paediatric Anaesthesia Dr Anna Englin Paediatric Anaesthetist, MMC

  2. Overview • Equipment/room set up • Crises we see in kids

  3. Equipment • Airway • Breathing • Circulation • Drugs • Environment/ exposure

  4. Anaesthesia checklist • Airway • Breathing • Circulation • Drugs • Environment/ exposure

  5. Airway • Infants and neonates have anatomical differences cf adults • Different sized equipment

  6. Face masks

  7. Airways • Lift tongue and epiglottis away from upper airway • Different sizes: measure from centre of incisors to angle of jaw • Nasopharyngeal airways

  8. LMA’s • Don’t forget in a difficult intubation! • Less reliable than in adults

  9. Intubation • laryngoscopes

  10. ETT size • ETT size = 4 +age/4 • Cuffed vs uncuffed

  11. Equipment • Airway • Breathing • Circulation • Drugs • Environment/ exposure

  12. Breathing • T piece vs closed circuit • Paediatric breathing circuit

  13. Equipment • Airway • Breathing • Circulation • Drugs • Environment/ exposure

  14. Circulation • ECG sometimes not used, mainly useful to detect bradycardia • Blood pressure lower • Arterial line setup is different

  15. Equipment • Airway • Breathing • Circulation • Drugs • Environment/ exposure

  16. Exposure • Neonates especially prone to hypothermia • Prevention of hypothermia • Operating theatre • Patient covering esp head • Warming blankets/ overhead heaters • Fluid warmers • Monitoring

  17. Paediatric crises

  18. Laryngospasm • Common and can be scary! • Risk factors • Active or recent URTI • Reactive airways • Airway surgery • Stimulation during light anaesthesia

  19. Features

  20. Treatment of laryngospasm • CPAP with 100%O2 • Propofol • Lignocaine: topical or IV 2mg/kg • Sux: 2mg/kg IV or 4mg/kg IM

  21. 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

  22. The end NB: no children were harmed in the making of this talk

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