Paediatric anaesthesia
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Paediatric anaesthesia · May 2005
Case ReportsUltrasound assessment of caudal catheter position in infants.
The positioning of caudally inserted epidural catheters is crucial to their effectiveness. However, level assessment can be difficult and time consuming. We report the use of ultrasound to assess the catheter position in three patients aged between 1 and 10 months. The advantages and disadvantages of this technique are discussed in relation to other methods of assessing caudal catheter placement.
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Paediatric anaesthesia · May 2005
Clinical assessment of the laryngeal tube in pediatric anesthesia.
The aim of this study was to evaluate a new device for airway management in children: the laryngeal tube (LT). ⋯ The LT is not recommended for children <10 kg. Over 10 kg, it provides a clear airway in most children, with a low rate of minimal additional maneuvers for sizes 2 and 3. The failure rate also decreases with the operator's training.
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Paediatric anaesthesia · May 2005
The use of physical restraints on paediatric intensive care units.
Physical restraints are used in critical care units in an attempt to reduce the risk of treatment interference. Their use remains controversial and there are concerns regarding the effectiveness and safety of restraint techniques. There are few data available on the prevalence of physical restraint use in Paediatric Intensive Care Units (PICU) in the UK and we have therefore conducted a cross-sectional survey to define current clinical practice. ⋯ Physical restraint is a commonly used technique on PICU in the UK. There is considerable variation in clinical practice and current clinical guidelines which are available do not deal specifically with children. Prospective randomized trials would be necessary to fully investigate the role of physical restraints amongst critically ill children.
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Paediatric anaesthesia · May 2005
Dimensions of the neonatal cricothyroid membrane - how feasible is a surgical cricothyroidotomy?
Airway management of the neonate remains a cornerstone in neonatal resuscitation which in most cases involves tracheal intubation. However, difficult intubations do occur. Cricothyroidotomy is recognized as an entry point below the vocal cords. This procedure becomes increasingly difficult in young children and is not recommended in children under the age of 5 years. Little is known about the anatomy of the neonatal airway, especially the size of the cricothyroid membrane. The aim of the study was to determine the dimensions of the cricothyroid membrane in neonates. ⋯ Results of this study indicate that the dimensions of the cricothyroid membrane are too small for passing a tracheal tube as the dimensions of the tube exceeds that of the cricothyroid membrane. This could fracture the cartilages of the larynx. The performance of a surgical cricothyroidotomy with passing of a tracheal tube is therefore strongly discouraged in neonatal patients.