Downs Syndrome Flashcards
What is Down’s Syndrome also known as?
Trisomy 21
What does the mnemonic ‘Always Anticipate Cardiac Risks, Neurological Patients Get Increased Infection’ represent?
Key considerations for Down’s syndrome patients
List three airway considerations for Down’s syndrome patients.
- Macroglossia
- Mandibular hypoplasia
- Subglottic stenosis
What is macroglossia?
Large tongue that complicates airway obstruction and mask ventilation
What is atlanto-axial instability?
Excessive movement at the junction between the first and second cervical vertebrae (C1-C2)
True or False: Up to 15% of Down’s syndrome patients have atlanto-axial instability.
True
What are common congenital heart defects found in Down’s syndrome patients?
- Atrioventricular septal defects (AVSD)
- Ventricular septal defects (VSD)
- Atrial septal defects (ASD)
- Patent ductus arteriosus (PDA)
What is a significant respiratory consideration for Down’s syndrome patients?
Increased susceptibility to respiratory complications
What is the impact of hypotonia on Down’s syndrome patients’ respiratory function?
Leads to ineffective cough and poor airway clearance
Fill in the blank: Patients with Down’s syndrome may have increased sensitivity to _______.
[sedatives and opioids]
What gastrointestinal condition is common in Down’s syndrome patients?
Gastroesophageal reflux disease (GERD)
What is a key infection risk for patients with Down’s syndrome?
Higher susceptibility to perioperative infections
What should be considered during the preoperative assessment of Down’s syndrome patients?
- Airway management
- Cardiovascular evaluation
- Respiratory status optimization
What are two considerations for pharmacology in Down’s syndrome patients?
- Increased sensitivity to sedatives and opioids
- Higher risk of respiratory depression
True or False: Down’s syndrome patients typically have a lower risk of aspiration during anesthesia.
False
What is the importance of monitoring in patients with significant cardiac disease during anesthesia?
To assess pulmonary hypertension and avoid complications
List two airway management tips for Down’s syndrome patients.
- Use a smaller-than-usual endotracheal tube size
- Consider awake fiberoptic intubation if difficult airway is anticipated
What is the role of preoperative antibiotics in Down’s syndrome patients?
To reduce the risk of perioperative infections
What are the effects of developmental delay on anesthesia in Down’s syndrome patients?
May affect cooperation during preoperative assessments
What should be avoided in patients with atlanto-axial instability during intubation?
Excessive neck manipulation
What can chronic constipation in Down’s syndrome patients lead to?
Increased risk of aspiration due to delayed gastric emptying
What should be done during postoperative care for respiratory function in Down’s syndrome patients?
Consider monitoring in a high-dependency unit (HDU) or intensive care setting
What is the recommended approach for titrating sedatives and opioids in Down’s syndrome patients?
Start with lower doses and titrate slowly
