Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2011
Retrospective audit of the air-Q intubating laryngeal airway as a conduit for tracheal intubation in pediatric patients with a difficult airway.
To assess the efficacy of the ILA as a conduit for tracheal intubation in pediatric patients with a difficult airway. ⋯ In a series of pediatric patients with difficult airways, the ILA was successfully used as a conduit for tracheal intubation in all patients. Visualization techniques may offer a greater degree of success in intubations through the ILA due to the potential for epiglottic down-folding in children.
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The International Organization for Standardization (ISO) recently published an International Standard (ISO 7376:2009) which specifies illuminance levels and tests for illumination from hook-on type laryngoscopes used for intubation. A clinical study examining luminance for laryngoscopy found that 100 cd·m(-2) was the minimum level acceptable for laryngoscopy. The purpose of this study was to measure the quality of light from laryngoscopes available for use by anesthetists in an anesthetic department and compare them to the ISO illuminance standard and published minimum acceptable luminance limits. ⋯ Laryngoscope light should be regularly audited. Results from these audits can be used to retire or repair substandard laryngoscopes to maintain acceptable standards of laryngoscope light. Audit results produce tangible evidence that is useful when applying for capital expenditure. Light measurements are not easy to make. There needs to be a convenient device to reliably measure laryngoscope illumination.
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Paediatric anaesthesia · Apr 2011
Case ReportsPreventing venous thrombosis in critically ill children: what is the right approach?
The incidence of venous thromboembolic (VTE) events in children has increased in recent years (J Neurosurg, 101, 2004, 32; J Thromb Haemost, 1, 2003, 1443) yet there is currently no consensus as to what VTE prophylaxis, if any, should be applied to the pediatric population. ⋯ There is no consensus in England and Wales as to which VTE prophylactic measures should be applied in patients <18 years of age. The National Institute for Health and Clinical Excellence (NICE) guidelines apply to adults only. Given the rarity of VTE events in children, it is unlikely that randomized controlled trials will provide the answer. We therefore propose that simple empirical measures be formally implemented in critically ill children to reduce the risk of developing this important but under-recognized condition.
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Paediatric anaesthesia · Apr 2011
Feasibility and efficacy of placement of continuous sciatic perineural catheters solely under ultrasound guidance in children: a descriptive study.
Placement of sciatic catheters with ultrasound and stimulating catheters is known. Literature regarding catheter placements with only ultrasound is limited. We aimed to investigate the feasibility of performing continuous sciatic nerve block exclusively with ultrasound guidance and minimal equipment. ⋯ We conclude that in children, continuous sciatic catheters can be accurately and efficaciously placed with minimal equipment with ultrasound alone.
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Paediatric anaesthesia · Apr 2011
Anesthesia can be safely provided for children in a high-field intraoperative magnetic resonance imaging environment.
To describe the challenges associated with providing safe anesthesia and perioperative care for children in a remote intraoperative magnetic resonance (iMR) operating room (OR) and to identify perioperative anesthesia outcomes, including adverse events related to the iMR environment. ⋯ Anesthesia and perioperative care of children in an iMR setting were associated with a very low incidence of complications, despite the duration of the procedures involved. Such success depends upon a cohesive team-based approach.