Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2020
How should we approach parental refusals of opioids on behalf of children in the perioperative setting? A practical approach based on ethical theory.
In the midst of the current opioid epidemic, we have encountered more parents who are concerned about the use of opioids in the perioperative setting. Some parents have completely refused the use of opioids on behalf of their children. ⋯ We propose a decision-making framework that focuses on improving communication and considering alternatives. Assessment of harm to the child from avoiding opioids, as well as potential harms from overriding parental autonomy must be undertaken prior to considering overriding parents.
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Paediatric anaesthesia · Aug 2020
Observational StudyUltrasound-guided Anatomical Evaluation of Right Internal Jugular Veinin Children Aged 0-2 Years: A Prospective Observational Study.
The right internal jugular vein is commonly preferred for central venous cannulation, and ultrasonographic assessment and guidance is the recommended technique for this procedure. Despite the safety and reliability of this technique, it requires specific training and experience as well as thorough knowledge of anatomy. ⋯ Our results support the current data for the high anatomical variability of the right internal jugular vein, highlighting the recommendation of the Rapid Central Vein Assessment (RaCeVA) protocol prior to and ultrasound guidance during catheterization of central veins.