Factors Predictive of Poor Behavioral Compliance During Inhaled Induction in Children

Varughese, Anna M.; Nick, Todd G.; Gunter, Joel B.; Wang, Yu; Kurth, C. Dean

doi:10.1213/ane.0b013e31817e616b

Cited by 58 publications

(62 citation statements)

References 22 publications

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“…Younger children (2-5 years of age) and patients who have been to the OR before are at higher risk of being stressed and uncooperative during the induction of anesthesia. 8 In addition, some patients will suffer from postoperative behavioral changes, including sleep difficulties, which may present to the pediatrician in the weeks after surgery. Recent studies have concluded that the likelihood of these maladaptive behaviors is higher if the child is anxious preoperatively.…”

Section: Introductionmentioning

confidence: 99%

The Pediatrician’s Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia

Goldschneider¹,

Cravero²,

Anderson³

et al. 2014

Pediatrics

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Pediatricians play a key role in helping prepare patients and families for anesthesia and surgery. The questions to be answered by the pediatrician fall into 2 categories. The first involves preparation: is the patient in optimal medical condition for surgery, and are the patient and family emotionally and cognitively ready for surgery? The second category concerns logistics: what communication and organizational needs are necessary to enable safe passage through the perioperative process? This revised statement updates the recommendations for the pediatrician' s role in the preoperative preparation of patients. Pediatrics 2014;134:634-641 INTRODUCTIONPrimary care providers, including pediatricians, are frequently called on to evaluate and psychologically prepare patients and families before a child undergoes a procedure requiring anesthesia or sedation. This policy statement identifies that primary care provider' s preoperative goals of care are as follows: to clearly define the child' s medical issue; to delineate the physiologic effects and limitations imposed by each condition; and to optimize the management of any comorbid conditions. Furthermore, the policy recommends that pediatricians facilitate essential communication about the historical, physical, and laboratory findings in children with unusual or complex medical histories with the anesthesiologist and/or surgeon to ensure safe perioperative care.The objectives of the present statement were twofold:1. to describe to pediatricians the issues of concern to anesthesiologists and surgeons to improve the effectiveness of medical consultations in preparing pediatric patients and families for the perioperative period; and 2. to present information that will encourage and facilitate communication among surgeons, anesthesiologists, medical subspecialists, pediatricians, and other primary care providers.

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Section: Introductionmentioning

confidence: 99%

The Pediatrician’s Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia

Goldschneider¹,

Cravero²,

Anderson³

et al. 2014

Pediatrics

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show abstract

“…All children received an inhalational induction with sevoflurane in an oxygen/nitrous oxide mixture in the presence of their parent or guardian. The induction compliance checklist consisting of 11 items was used to record the child's behaviour at induction [8]. Following induction of anaesthesia, an intravenous cannula was inserted and standard monitoring attached (ECG, pulse oximeter, non-invasive blood pressure, end-tidal gas analysis).…”

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confidence: 99%

A comparison of single-dose dexmedetomidine or propofol on the incidence of emergence delirium in children undergoing general anaesthesia for magnetic resonance imaging

et al. 2014

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“…The induction compliance measure, collected as part of the anesthesia quality assurance program, ensured that while changes were being made to the premedication order entry process, children who met criteria received premedication. 8 The numbers of cases conducted per week were monitored to ensure that while scheduling changes were being made, the volume of cases did not decrease.…”

Section: Methods Of Evaluation and Analysesmentioning

confidence: 99%

“…The second was to use a clinical algorithm to facilitate this early decision. 8 The third was to eliminate the routine prescription of acetaminophen for postoperative pain relief to be administered preoperatively in the SDS clinic. A literature search did not provide evidence to support the use of acetaminophen for this purpose.…”

Section: Figurementioning

confidence: 99%

Improving On-Time Start of Day and End of Day for a Pediatric Surgical Service

et al. 2013

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BACKGROUND AND OBJECTIVE: In multicase pediatric ear, nose, and throat operating rooms (ORs), brief delays in early case start times often produce a cascading effect of lengthy delays by the end of the day and can often lead to patient, family, and staff dissatisfaction and increased labor costs due to unplanned overtime. We sought to improve actual end of day relative to scheduled end of day from 40% to 60%.METHODS: Key drivers of the process included case scheduling, ordering of sedative medications, and nurse availability in the postanesthesia care unit to receive the patient from the anesthesia provider. A multidisciplinary team conducted a series of tests of change addressing the various key drivers. Data were collected by using an independent, impartial data collector as well as being extracted from the hospital information technology system. Data were analyzed by using control charts and statistical process control methods. RESULTS:The percentage of ORs ending on time increased from 40% to 60%. Appropriate scheduling of complex cases increased from 10% to 87%, and accurate scheduling of case duration improved from 21% to 48%. Timely premedication increased from 55% to 90% and immediate availability of a nurse in the postanesthesia care unit from 68% to .90%. CONCLUSIONS:By applying quality-improvement methods, significant improvements were made in a multicase pediatric ear, nose, and throat OR. The impact can be significant by reducing wait times for patients, as well as staff overtime for the institution. Pediatrics 2013;132:e219-e228 AUTHORS:

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Factors Predictive of Poor Behavioral Compliance During Inhaled Induction in Children

Cited by 58 publications

References 22 publications

The Pediatrician’s Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia

The Pediatrician’s Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia

A comparison of single-dose dexmedetomidine or propofol on the incidence of emergence delirium in children undergoing general anaesthesia for magnetic resonance imaging

Improving On-Time Start of Day and End of Day for a Pediatric Surgical Service

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