Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2022
Practice what you teach: an approach to integrate airway education for experienced anesthesia clinicians.
The COVID-19 pandemic has disrupted clinician education. To address this challenge, our divisional difficult airway program (AirEquip) designed and implemented small-group educational workshops for experienced clinicians. Our primary aim was to test the feasibility and acceptability of a small-group, flexible-curriculum skills workshop conducted during the clinical workday. Secondary objectives were to evaluate whether our workshop increased confidence in performing relevant skills and to assess the work-effort required for the new program. ⋯ It is feasible and acceptable to incorporate expert-led skills training into the clinical workday. Alongside conferences and large-format instruction, this modality enhances the way we are able to share knowledge with our colleagues. This concept can likely be applied to other skills in various clinical settings.
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Paediatric anaesthesia · Sep 2022
Carotid Doppler ultrasonography as a method to predict fluid responsiveness in mechanically ventilated children.
The aim of this study was to investigate whether respiratory variations in carotid and aortic blood flows measured by Doppler ultrasonography could accurately predict fluid responsiveness in critically ill children. ⋯ Analysis of respiratory changes in carotid and aortic blood flows are accurate methods for predicting fluid responsiveness in children under invasive mechanical ventilation.
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Paediatric anaesthesia · Sep 2022
Observational StudyThe Association Between Carotid Flow Time and Fluid Responsiveness in Children Under General Anesthesia.
Fluid administration in children undergoing surgery requires precision, however, determining fluid responsiveness can be challenging. Ultrasound has been used widely in the emergency department and intensive care units as a noninvasive, bedside manner of determining volume status, but the intraoperative period presents unique challenges as often the chest and abdomen are inaccessible for ultrasound. We investigate whether carotid artery ultrasound, specifically carotid flow time, can be used to determine fluid responsiveness in children under general anesthesia. ⋯ Flow time increases with initiation of positive pressure ventilation and after administration of a fluid bolus. FTc may serve as an indicator of fluid status but does not predict fluid responsiveness in children under general anesthesia.
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Paediatric anaesthesia · Sep 2022
Effect of a carbohydrate lollipop on the gastric volume of fasted pediatric patients.
Preoperative fasting is part of routine practice. Children subjected to prolonged preoperative fasting often suffer adverse effects. Consuming a preoperative lollipop may lessen their anxiety and have clinical benefits. ⋯ Consuming a standard lollipop did not affect the gastric volume of fasted pediatric patients.
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Paediatric anaesthesia · Sep 2022
Case ReportsDiagnostic and therapeutic application of thoracic epidural in a child with intractable cardiac arrhythmias. A case report.
A 3-year-old boy presented with episodes of uneasiness and transient loss of consciousness. Atrial tachyarrhythmias with rapid ventricular rate was diagnosed and initially unsuccessfully treated with oral antiarrhythmic drugs. Subsequent Holter monitoring revealed ventricular arrhythmias. ⋯ Initially, sympathectomy was achieved using a continuous high thoracic epidural block and was performed to ascertain the efficacy of the thoracic sympathectomy. This successfully reduced the ventricular arrhythmias and the need for antiarrhythmic agents. The epidural infusion was also used for pain relief following the subsequent surgical sympathectomy.