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Minor Illnesses & Common Pediatric Procedures
 

Minor Illnesses & Common Pediatric Procedures

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    Minor Illnesses & Common Pediatric Procedures Minor Illnesses & Common Pediatric Procedures Presentation Transcript

    • MINOR
ILLNESSES
AND
COMMON

 PAEDIATRIC
PROCEDURES
 Interac6ve
Discussion
 Dr
Moataz
Abdelrahman
 Consultant
Paediatric
Anaesthe2st
 Central
Manchester
University
Hospitals
 Royal
Manchester
Children’s
Hospital,
UK

    • CANCELLATION
 •  Problems
with
cancella6on
of
surgery
 –  Pa,ent
 –  Family
 –  System
 •  Why
postpone
 –  Op,mise
clinical
condi,on
 •  Individual
basis
 –  Be?er
resources/equipment
 –  ICU
 –  Monitoring
 –  Inves,ga,on
 –  Other

    • COMMON
ILLNESSES
 •  CVS
 –  Murmurs
 •  Respiratory
 –  Cold
 –  Cough
 –  Laryngi,s/tonsilli,s
middle
ear
 –  Asthma
 •  Infec6ons
 –  Rashes
 –  Temperature
 –  Diarrhoea
and
or
vomi,ng
 –  Local
eye
infec,on
 –  Urinary
tract
infec,on

    • •  Miscellaneous
 –  Immuniza,on
 –  Child
on
an,bio,cs
 –  Child
on
an,epilep,c
medica,ons

    • Murmurs
 
The
vast
majority
of
children
found
to
have
a
murmur
pre‐opera7vely
 have
an
innocent
murmur

 •  Innocent
murmurs
 –  SoK

 –  Early
systolic


 –  No
thrill
or
abnormal
cardiac
impulses


 –  Not
associated
with
cardiac
signs
or
symptoms
 •  Pathological
murmurs
 –  All
diastolic
murmurs
 –  All
pansystolic
murmurs
 –  Late
systolic
 –  Cardiac
signs
or
symptoms

    • Murmurs
 •  If
a
child
is
found
to
have
a
murmur
prior
to
elec6ve
surgery
 a
history
and
cardiac
examina6on
should
be
performed
and
 an
ECG
done
 •  In
the
presence
of
a
murmur
an
echocardiogram
and
cardiac
 opinion
is
indicated
prior
to
surgery
if:
 –  The
child
is
younger
than
a
year
 –  The
murmur
fits
pathological
criteria
 –  There
are
cardiac
signs
or
symptoms
 –  Evidence
of
LVH
or
RVH

    • Upper
Respiratory
Tract
Infec6on
 •  GA
in
URTI
is
associated
with:
 –  Hypoxaemia
 –  Laryngospasm
 –  Bronchospasm
 –  Death
 
Overall
risk
of
events

2‐7
,mes
 
With
ETT
risk
of
events

10
,mes

    • •  Consider
GA
in
URTI
(mild)
 –  Not

unwell
 –  Clear
nasal
discharge
 –  Clear
chest
 –  Age
≥
5
years
 –  Age
1‐5
years
assess
risk/benefit

 •  Postpone
Surgery
in
URTI
 –  Fever
≥
38°C
(37.5°C)
 –  Mucopurulent
nasal
secre,ons
 –  Lower
repiratory
symptoms/signs
 –  
WCC
 –  Age
<
1
year
even
with
mild
URTI
?

    • VACCINATION
 •  Effect
of
GA
on
immunity
 •  Symptoms
and
signs
interfering
with
post‐opera,ve
 complica,ons
clinical
picture
 •  Recent
DOH
opinion
Paeds
guidelines/vaccina,on.pdf
 –  Imminent
GA
 –  Imminent
Surgery

 "
 NOT
A
CONTRAINDICATION
TO
VACCINATION

    • THANK
YOU