Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2012
ReviewPediatric airway management: current practices and future directions.
Management of a pediatric airway can be a challenge, especially for the non-pediatric anesthesiologists. Structured algorithms for an unexpected difficult pediatric airway have been missing so far. A recent step wise algorithm, based on the Difficult Airway society (DAS) adult protocol, is a step in the right direction. ⋯ The exact role of these devices in routine and emergent situations is still evolving. Recent advances in simulation technology has become a valuable tool in imparting psychomotor and procedural skills to trainees and allied healthcare workers. Moving toward the goal of eliminating serious adverse events during the management of routine and difficult pediatric airway, authors propose that institutions develop a dedicated Difficult Airway Service comprising of a team of experts in advanced airway management.
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Regional anesthesia in children is an evolving technique with many advantages in perioperative management. Although most regional anesthesia techniques are sufficiently described in the literature, the implementation of these techniques into daily clinical practice is still lacking. The main problems associated with pediatric regional anesthesia (PRA) include the appropriate selection of blockade, the management around the block, and how to teach these techniques in an optimal manner. This review article provides an overview of these 'hot' topics in PRA.
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Surgical safety has emerged as a significant global public health concern with reported mortality rates varying tremendously between developing and industrialized countries. This manuscript reviews some of the challenges encountered in providing safe anesthesia care in the humanitarian space; identifies the difficulties with providing high-quality education in developing countries; and describes how audits and quality improvement databases enhance our understanding of the nature and causes of harm to patients to inform the development of strategies for improvement.