Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0010
R. Craig
In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.
{"title":"Advanced vascular access","authors":"R. Craig","doi":"10.1093/med/9780198755791.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0010","url":null,"abstract":"In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130898527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This chapter covers the perioperative management of both elective (e.g. scoliosis surgery) and emergency (e.g. fractured limb) orthopaedic procedures. For each pathology, the patient population and the surgical management are described. Thereafter, the perioperative care is described in a concise but thorough manner, explaining everything from preoperative assessment to the analgesic regimes employed to manage these often-challenging patients.
{"title":"Orthopaedic surgery","authors":"N. Raj","doi":"10.1136/pgmj.14.153.225","DOIUrl":"https://doi.org/10.1136/pgmj.14.153.225","url":null,"abstract":"This chapter covers the perioperative management of both elective (e.g. scoliosis surgery) and emergency (e.g. fractured limb) orthopaedic procedures. For each pathology, the patient population and the surgical management are described. Thereafter, the perioperative care is described in a concise but thorough manner, explaining everything from preoperative assessment to the analgesic regimes employed to manage these often-challenging patients.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128764396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0023
A. Hunt
This chapter describes anaesthesia for paediatric ophthalmic cases. Management is generally straightforward, but is not without its problems and complications. Most procedures are day cases, but they may involve children who are unable to comply with tests when awake, children having multiple procedures, or syndromes associated with their ophthalmic condition. Ages range from the neonate to teenagers and involve procedures such as examination under anaesthesia (EUA), squint surgery, cataract surgery (and its complications), nasolacrimal surgery, oculoplastic surgery, and glaucoma surgery. The side effects of ocular drops are discussed, as are the risks of surgery in and around the eye, e.g. the oculocardiac reflex. Also covered are emergencies such as ‘the penetrating eye injury’ scenario.
{"title":"Ophthalmology surgery","authors":"A. Hunt","doi":"10.1093/med/9780198755791.003.0023","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0023","url":null,"abstract":"This chapter describes anaesthesia for paediatric ophthalmic cases. Management is generally straightforward, but is not without its problems and complications. Most procedures are day cases, but they may involve children who are unable to comply with tests when awake, children having multiple procedures, or syndromes associated with their ophthalmic condition. Ages range from the neonate to teenagers and involve procedures such as examination under anaesthesia (EUA), squint surgery, cataract surgery (and its complications), nasolacrimal surgery, oculoplastic surgery, and glaucoma surgery. The side effects of ocular drops are discussed, as are the risks of surgery in and around the eye, e.g. the oculocardiac reflex. Also covered are emergencies such as ‘the penetrating eye injury’ scenario.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128062839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0020
N. Murali
This chapter describes the perioperative management of children presenting to the medical specialties, who often have comorbidities and frequent theatre episodes. Endoscopic procedures are the mainstay of diagnosis and treatment in gastroenterology. Endoscopy lists require an anaesthetist to plan for a high turnover, potentially in a remote site. Standard general anaesthetic (GA) techniques, along with alternative approaches, are discussed. Ingestion of caustic substances and foreign bodies in children and their management are discussed Children with oncological conditions commonly have GA for diagnostic and therapeutic procedures. Anaesthetists also need to provide assistance in siting tunnelled lines and in pain management. The salient clinical features, staging procedures, and treatment options of common childhood malignancies are considered, including bone marrow transplantation and managing an immunocompromised child. The multiple challenges of anaesthetizing children having radiotherapy are considered. Indications, contraindications, and equipment preparation for both diagnostic and therapeutic bronchoscopies are discussed. Children having these procedures usually have comorbidities and a high probability of significant decompensation during the procedure. Clinical aspects of juvenile idiopathic arthritis (JIA), including its definition, classification, diagnostic features, and salient treatment aspects, are discussed. Anaesthetic considerations for joint injections are described. Special attention is paid to careful assessment of anaesthetic-specific features such as difficult airway, unstable cervical spine, and systemic changes of JIA, and the respective anaesthetic precautions are discussed.
{"title":"Medical specialties","authors":"N. Murali","doi":"10.1093/med/9780198755791.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0020","url":null,"abstract":"This chapter describes the perioperative management of children presenting to the medical specialties, who often have comorbidities and frequent theatre episodes. Endoscopic procedures are the mainstay of diagnosis and treatment in gastroenterology. Endoscopy lists require an anaesthetist to plan for a high turnover, potentially in a remote site. Standard general anaesthetic (GA) techniques, along with alternative approaches, are discussed. Ingestion of caustic substances and foreign bodies in children and their management are discussed Children with oncological conditions commonly have GA for diagnostic and therapeutic procedures. Anaesthetists also need to provide assistance in siting tunnelled lines and in pain management. The salient clinical features, staging procedures, and treatment options of common childhood malignancies are considered, including bone marrow transplantation and managing an immunocompromised child. The multiple challenges of anaesthetizing children having radiotherapy are considered. Indications, contraindications, and equipment preparation for both diagnostic and therapeutic bronchoscopies are discussed. Children having these procedures usually have comorbidities and a high probability of significant decompensation during the procedure. Clinical aspects of juvenile idiopathic arthritis (JIA), including its definition, classification, diagnostic features, and salient treatment aspects, are discussed. Anaesthetic considerations for joint injections are described. Special attention is paid to careful assessment of anaesthetic-specific features such as difficult airway, unstable cervical spine, and systemic changes of JIA, and the respective anaesthetic precautions are discussed.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117119991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0021
Elizabeth Wright
This chapter will enable trainee anaesthetists to understand the practical considerations of neuroanaesthesia for children and neonates undergoing elective and emergency neurosurgical procedures in a tertiary centre. It includes the management of head injury, the use of intraoperative MRI, and anaesthesia for neuroradiology.
{"title":"Neurosurgery","authors":"Elizabeth Wright","doi":"10.1093/med/9780198755791.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0021","url":null,"abstract":"This chapter will enable trainee anaesthetists to understand the practical considerations of neuroanaesthesia for children and neonates undergoing elective and emergency neurosurgical procedures in a tertiary centre. It includes the management of head injury, the use of intraoperative MRI, and anaesthesia for neuroradiology.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130814554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0014
Steve Roberts
Day surgery is an immensely important aspect of any hospital’s workload, with innovations in both surgery and anaesthesia allowing a greater array of procedures to be delivered in this manner. The benefits to children and families is huge, particularly in avoiding the psychological upset of an overnight admission. This chapter describes the facilities and resources required to safely deliver day surgery for children, as well as the general principles of patient selection and anaesthetic practice.
{"title":"Day-case surgery","authors":"Steve Roberts","doi":"10.1093/med/9780198755791.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0014","url":null,"abstract":"Day surgery is an immensely important aspect of any hospital’s workload, with innovations in both surgery and anaesthesia allowing a greater array of procedures to be delivered in this manner. The benefits to children and families is huge, particularly in avoiding the psychological upset of an overnight admission. This chapter describes the facilities and resources required to safely deliver day surgery for children, as well as the general principles of patient selection and anaesthetic practice.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127702992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0016
E. Carver
Dental and oral surgery is one of the commonest reasons for providing anaesthesia to children in the UK. Other than simple extractions for caries, patients may present for restorative work and to facilitate orthodontic treatment. A familiarity with the techniques involved is essential, including that of airway maintenance with a nasal mask, which is still used in some centres.
{"title":"Dental and oral surgery","authors":"E. Carver","doi":"10.1093/med/9780198755791.003.0016","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0016","url":null,"abstract":"Dental and oral surgery is one of the commonest reasons for providing anaesthesia to children in the UK. Other than simple extractions for caries, patients may present for restorative work and to facilitate orthodontic treatment. A familiarity with the techniques involved is essential, including that of airway maintenance with a nasal mask, which is still used in some centres.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130912572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0018
N. Raj
This chapter covers the range from common day-case procedures (e.g. circumcision) to major emergency cases (e.g. trachea-oesophageal fistula). Its aim is to explain the various pathologies and their subsequent surgical management. The reader will find a thorough and concise perioperative management plan covering everything from preoperative assessment to pain management. The practicalities of anaesthetizing neonates are discussed. The implications and management of laparoscopic methods in children are also covered.
{"title":"General surgery and urology","authors":"N. Raj","doi":"10.1093/med/9780198755791.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0018","url":null,"abstract":"This chapter covers the range from common day-case procedures (e.g. circumcision) to major emergency cases (e.g. trachea-oesophageal fistula). Its aim is to explain the various pathologies and their subsequent surgical management. The reader will find a thorough and concise perioperative management plan covering everything from preoperative assessment to pain management. The practicalities of anaesthetizing neonates are discussed. The implications and management of laparoscopic methods in children are also covered.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127314203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0029
P. Murphy, S. Stibbards
This chapter covers resuscitation management and is based on the 2015 Resuscitation Council (UK) guidelines (so it is important that the reader ensure there have been no changes to the guidelines since the publication of this book). The presentation and management of the choking child is described. Thereafter, dysrhythmia management and basic, advanced, and neonatal resuscitation are described. Finally, the management of the hypothermic drowned child is discussed. A list of emergency drugs and their doses is provided for quick reference.
{"title":"Resuscitation","authors":"P. Murphy, S. Stibbards","doi":"10.1093/med/9780198755791.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0029","url":null,"abstract":"This chapter covers resuscitation management and is based on the 2015 Resuscitation Council (UK) guidelines (so it is important that the reader ensure there have been no changes to the guidelines since the publication of this book). The presentation and management of the choking child is described. Thereafter, dysrhythmia management and basic, advanced, and neonatal resuscitation are described. Finally, the management of the hypothermic drowned child is discussed. A list of emergency drugs and their doses is provided for quick reference.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"2007 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127308142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.1093/med/9780198755791.003.0007
N. Masip
Maintenance of anaesthesia can be achieved by inhaled volatile agents, continuous infusion of intravenous drugs (TIVA), or a combination of both techniques. During anaesthetic maintenance, it is important to ensure normovolaemia, taking into account pre-existing deficits and ongoing losses during surgery. In certain cases, special considerations regarding intraoperative blood glucose control should be taken (e.g. neonates). In specific situations, blood transfusion of red cells or other blood components may be necessary. Anaesthetists must be prepared to manage intraoperative problems such as hypoxia, airway obstruction, laryngospasm, bronchospasm, hypotension, massive haemorrhage, dysrhythmias, anaphylaxis, hypothermia, hyperthermia, and malignant hyperthermia. This chapter provides a simple and focused approach to dealing with these issues.
{"title":"Intraoperative care","authors":"N. Masip","doi":"10.1093/med/9780198755791.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780198755791.003.0007","url":null,"abstract":"Maintenance of anaesthesia can be achieved by inhaled volatile agents, continuous infusion of intravenous drugs (TIVA), or a combination of both techniques. During anaesthetic maintenance, it is important to ensure normovolaemia, taking into account pre-existing deficits and ongoing losses during surgery. In certain cases, special considerations regarding intraoperative blood glucose control should be taken (e.g. neonates). In specific situations, blood transfusion of red cells or other blood components may be necessary. Anaesthetists must be prepared to manage intraoperative problems such as hypoxia, airway obstruction, laryngospasm, bronchospasm, hypotension, massive haemorrhage, dysrhythmias, anaphylaxis, hypothermia, hyperthermia, and malignant hyperthermia. This chapter provides a simple and focused approach to dealing with these issues.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131248365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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