Anaesthesia
-
The care of sick children can be challenging for the anaesthetist who is only involved in the occasional care of paediatric patients. This paper outlines the care of medical and surgical paediatric emergencies for which an anaesthetist working at a district general hospital or equivalent may encounter. Conditions discussed include paediatric respiratory emergencies, sepsis, status epilepticus, the acute abdomen in the newborn, intussusception, the bleeding tonsil, trauma and the child with burns.
-
In this second article we examine the principles underlying delivery of the components of anaesthesia. Topics considered include anaesthetic technique, management of the airway and lung ventilation, induction and maintenance of anaesthesia, patient monitoring including the place of cardiac output devices. We summarise recent research on the management of shock and sepsis syndromes including goal directed therapy and examine some controversies around intravenous fluid therapy. Finally, we discuss intra-operative awareness and challenges during emergence including peri-operative cognitive dysfunction.