Minor Illnesses & Common Pediatric Procedures

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Minor Illnesses & Common Pediatric Procedures

  1. 1. MINOR
ILLNESSES
AND
COMMON

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

  2. 2. 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

  3. 3. 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

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

  5. 5. 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

  6. 6. 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

  7. 7. 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

  8. 8. •  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
?

  9. 9. 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

  10. 10. THANK
YOU


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