Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2013
Improving on-time starts for patients scheduled with general anesthesia in a MRI suite.
We applied quality improvement methodology to identify unnecessary, redundant parts of processes that can lead to delayed on-time starts for patients scheduled with general anesthesia (GA) in the radiology department. ⋯ Process improvement projects in anesthesia can yield positive results, using small incremental standardized changes. We used a quality improvement methods to successfully improve on-time start for patients scheduled with GA in high-volume MRI suite.
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Paediatric anaesthesia · Jul 2013
Case ReportsUse of the Bonfils intubating fibrescope in a baby with a severely compromised airway.
We report the successful use of a 2-mm rigid Bonfils intubation endoscope as a rescue device in a 5-week-old baby presenting with an unstable airway due to massive macroglossia and multiple hemorrhagic lymphangiomata compressing the airway and resulting in a Cormack and Lehane grade 4 view. The limited intraoral space rendered it impossible to visualize the laryngeal inlet or insert a laryngeal mask, Glidescope or Airtraq blade into the patient's mouth. A 2-mm Bonfils fibrescope passed easily into the patient's mouth and facilitated a grade 1 view of the laryngeal inlet with subsequent successful intubation at first attempt with a 3.5-mm uncuffed endotracheal tube. ⋯ In our case, the infant's airway was compromised as a result of a receding mandible, large protruding tongue, glottic distortion, and limited intraoral space. This prevented the use of bulkier rescue airway devices with the potential for traumatic manipulation, which could have lead to rapid deterioration of an already unstable airway. We feel that many clinicians are unaware of the benefits of the Bonfils fibrescope and suggest further studies to increase its use in elective and emergency situations.
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Paediatric anaesthesia · Jul 2013
Biography Historical ArticleAlan Conn; his role in the development of the anesthesia department at Toronto SickKids.
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Paediatric anaesthesia · Jul 2013
Utilizing integrated facility design to improve the quality of a pediatric ambulatory surgery center.
The aim was to use Integrated Facility Design (IFD) to design a surgery center that enhances the delivery of health care by developing processes that provide highly efficient patient, family, and provider flows while adding value and utilizing costly resources effectively. ⋯ The use of IFD in the design of a pediatric ambulatory clinic and surgery resulted in significant cost savings and improved clinical efficiency.
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Paediatric anaesthesia · Jul 2013
Biography Historical ArticleTom Allen and the Adelaide Childrens Hospital.