Paediatric Periooperative

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Fichas sobre Paediatric Periooperative, creado por Elizabeth Then el 12/06/2018.
Elizabeth Then
Fichas por Elizabeth Then, actualizado hace más de 1 año
Elizabeth Then
Creado por Elizabeth Then hace alrededor de 6 años
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Definitions of paediatric patients Premature - born before 37 weeks Newborn - just born Neonate - less than 4 weeks old Infant - less than 1 years old Child - 1 - 8 years Adolescent - 10 - 17 years
Differences cardiac system removal of placenta from circulation increasing systemic vascular resistance decreasing pulmonary vascular resistance true closure of PDA 2-3 weeks - critical transitional circulation Myocardial cell mass less developed - prone to biventricular failure, volume loading, poor tolerance to afterload, heart rate dependent CO - true for young infants
Differences Respiratory system Small airway diameter - increased resistance little support from ribs and cartilage more pliable chest wall collaspe increased with negative intra thoracic pressure diaphragm and intercostals dont achieve adult muscle fibres until 2 yrs Obligate nasal breathers Atelectasis more common - decrease residual capacity, number of alveoli alveolar ventilation/FRC - infants 5:1 increase RR
Differences - airways large tongue higher located larynx epiglottis short and stubby, angled over inlet angled vocal cords,
Body surface area not proportioned same as adults - heat loss massive via head
Types of surgical procesures elective - ENT, general, plastics, ortho Emergency - immediately after birth, result of trauma
Anaesthetic implications environment - aesthetics and parent involvement Equipment - smaller agents - dose changes approaches - GA, regional or both
Theatre implications warm ++++, difficulty with maintaining temp, smaller instruments, smaller dressings
Postanaesthetic recovery considerations purpose of PARU - monitoring, detection, prevention of complications, parent involvement, discharge criteria
Psychological considerations frightening and isolating, child-friendly, child's previous experience, anxious, fear of handing over child
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