Flashcards in Basic principles of Peds Deck (81)
deep tracheal extubation requires an organized plan.
in order to extubate the trachea deep, what must the depth of inhalational anesthesia be?
1.5 -2 x MAC
example: 2 yr old
-MAC of Sevo = 2%
deep extubation, MAC needs to be 3-4%
Emergence delerium has a peak incidence in children of what ages
emergence delerium is more common after certain anesthetics. order of likelyhood:
sevo ~ des~ iso > halothane ~ TIVA
how long does emergence delerium usually last?
how can it be terminated?
-terminate spontaneously OR after an IV dose of:
many parents express more concern about the risk of _____ than those of the surgery.
risks of anesthesia than those of the surgery
each child and family must be evaluated individually. what is good for one child and family...
may not be good for the next
max stress for parents. minimum on infant (not old enough to fear strangers)
Max fear of separation.
significant post-op emotional upset and behavior regression
cognitive development and increased temper tantrums
6mos - 4 yrs
Concern about body integrity
understands processes and explanations
8yrs - adolescence
self esteem and body image issues
developing sexual characteristics
fears loss of dignity
cyanosis is likely associated with what CV condition?
right to left shunt
a murmur may be related to what CV condition?
hx of neuromuscular dx? what might this indicate?
hypoglycemia and adrenal insufficiency in childs hx may indicate use of what medication?
vaccinations may have been recent in a child presenting to surgery. what must anesthesia provider consider?
- whether the iummunomudulatory effects of anesthesia and surgery might affect the efficacy and safety of the vaccine.
-whether the inflammatory responses to the vaccine will alter the perioperative course
in peds, what anesthetic agents are associated with undesirable bradycardia?
to prevent the undesirable bradycardia associated with some anesthetic agents (halothane and succinylcholine)
to minimize the autonomic vagal reflexes manifested during surgical manipulations (e.g., laryngoscopy, strabismus repair) what agents are used?
what is more commonly used and blocks the vagus nerve more effectively than scopolamine?
factors associated with laryngospasm include:
2. URTI recently
3. hx of reactive airway disease
4. second hand smoke exposure
5. airway surgery
6. airway devices (ETT, LMA)
7. stimulation of glottis during light plane
8. secretions in oropharynx
9. inhaled anesthesia (des and iso)
10. **inexperienced anesthesia provider
laryngospasm risk is greater in infants than older children and adults; the risk decreases with