Pediatric Anesthesia pt2.0 Flashcards
What age groups of pediatric patients are most prone to parental separation? Which are less prone?
- <9 months: Less prone
- 1-3 years: Most prone
What non-pharmacologic intervention can be done to alleviate preop anxiety in a 1-3 year old?
Distraction
What non-pharmacologic intervention can be done to alleviate preop anxiety in a 3-6 year old?
Preop play
7 - 12 year olds require more ____ and want ___?
7 - 12 year olds require more explanation and want to actively participate?
What age group yields the most stress for the parent?
0 - 6 months
What age group begins to understand processes and explanation and have concerns about body integrity?
4 - 8 years
What age group tolerates parental separation well, may interpret everything literally, and may fear waking up or not waking at all?
8 year - adolescence
What other preoperative assessment questions may be pertinent regarding a pediatric patient (different than an adult)?
- Term birth
- NICU Hx
- 2nd hand smoke
- parental history
Extremely loose child teeth may indicate what?
may need to pull before intubation to reduce risk of aspiration
What age in pediatrics is a significant predictor of difficult airway?
age < 1 year
Micrognathia, small oral opening, and zygomatic hypoplasia are characteristic of what syndrome?
Treacher Collins Syndrome
Micrognathia, glossoptosis, cleft palate, and cervical dysfunction are characteristic of what?
Pierre-robin sequence
Atlantooccipital abnormalities, small oral cavity, and macroglossia (large tongue) are characteristic with what syndrome?
Down syndrome
Review this chart for associated difficult airway syndromes:
Viral respiratory infections can cause what airway conditions that are problematic for anesthesia?
- inflammation
- airway edema
- increased secretions
- Reactive airway
What perioperative respiratory adverse events (PRAE) may be associated with URI?
- Bronchospasm
- Laryngospasm
- Atelectasis
- Postintubation croup
- bacterial pneumonia
There is a ____ incidence of PRAE with IV induction vs inhalational induction?
There is a decreased incidence of PRAE with IV induction vs inhalational induction?
What symptomology would the provider most likely need to cancel for a pediatric elective case?
- Purulent drainage
- Fever
- Lethargic
- Wheezing
- Child < 1
- persistent cough
Bronchial hyperreactivity may persist for up to ____ after URI??
May persist up to 6+ weeks
How long after resolution of URI symptoms should a case be postponed before undergoing anesthesia?
2 weeks after resolution of symptoms
Review this Pediatric cold algorithm:
What are the npo guidelines for various meals and substances?
- 2 hours: Clear liquids
- 4 hours: breast milk
- 6 hours: formula, nonhuman milk, light meal
- 8 hours: regular meal (fatty foods)
OPA size generally correlates with what measurement? What about an NPA?
- OPA: corner of mouth to edge of mandible
- NPA: tip of nose to edge of mandible (or tragus)
An OPA that is too large would cause what?
Can lead to worsened airway obstruction by pushing down the epiglottis
