Professional Documents
Culture Documents
Physiologic differences
Preoperative evaluation
NPO requirements
Premedication
Anesthetic techniques
Important Concept
The pediatric patient is not a
small adult
Pediatric Anatomy and
Physiology
The Pediatric Airway
Newborn CO = 4 ml/beat
4:2:1 Rule
4 ml/kg/hr 1st 10 kg +
2 ml/kg/hr 2nd 10 kg +
Infant = 80 ml/kg
3 months = 30%
6 months = 35%
HgB F
Reduced 2,3 DPG
Hypotermia Causes:
Increased oxygen consumption
Increased PVR
Increased SVR
R to L shunting
Preventing Hypothermia
Warm IV fluids
Humidify gases
Preoperative Evaluation
Preop Preparation
2. Fear of separation
explain exactly what will happen; what you will do then do it that way.
(Be trustworthy!)
Upper airway
Chest
Coexisting disease
Lab Testing
Pre-oxygenate ?
Nitrous oxide ?
Which agent ? X
Mask management
Endotrachial intubation
Pediatric blade
Tube depth:
(Age divided by 2) + 12
induction
Narcotics
wake up quickly
Muscle Relaxants
Succinylcholine
May use IV or IM
Response is variable
Be light weight
Hypothermia
Nausea and vomiting (prophylactic ondansteron)
Postoperative pain (self reported or physiologic signs
including hypertension, tachycardia, agitation, nausea and
vomiting; treat severe pain with fentanyl or morphine iv)
Fear associated with awakening in a strange environment
(permit parent to be present)