Medical assessment of the paediatric patient

Black, Ann E.

doi:10.1093/bja/83.1.3

Cited by 11 publications

(11 citation statements)

References 66 publications

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“…Only then can the assessment begin with questions and physical examination relevant to the conduct of the anaesthetic and the procedure, which should guide the need for special investigations. With the information that these steps provide, the consultant should be in a position to identify the potential problems and to consider what special preparation and planning will be necessary to manage them . Sharing these considerations with family comes next.…”

Section: Discussionmentioning

confidence: 99%

Paediatric pre‐operative anaesthetic clinic: A survey of consultant‐led caseload and outcomes

Chin

Macrae

Sury

2019

J Paediatrics Child Health

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Aim The role of pre‐operative anaesthetic clinics (POAC) in adult practice is well‐established and is developing in paediatric hospitals in the UK. Methods We carried out a retrospective survey of all patients assessed in our POAC by a consultant, determining the pre‐operative problems and the perioperative anaesthetic interventions and outcomes. Results In 2016, 537 patients were seen by a consultant: the median age was 5.5 years (interquartile range 2.2–10.2) and median weight was 18.7 kg (interquartile range 12–28.7). 77% were ASA3 and 4% were ASA4. Seventy‐five percent of patients referred for consultant assessment had a problem with at least one of the following four major body systems: cardiac (37%), respiratory (26%), airway (18%) and neurodevelopment (14%), Fifteen percent of these patients had two of these systems affected, and 3% had three or more. The rate of cancellation due to significant risk was 2.6% (n = 14): nine had significant cardiac risk and five had respiratory reasons. The rate of serious perioperative problems was 2.8% (n = 15): six were cardiac, six were respiratory, two neurological and one coagulation. Cardiac and airway problems occurred during anaesthesia, whereas problems relating to respiratory and neurological disease were post‐operative. Of the 15 patients with three or more body system problems, 5 were cancelled or had a perioperative complication causing deterioration, 5 had a major complication but recovered fully and 5 proceeded to general anaesthesia (GA) without serious event. There were no deaths during GA or within 30 days. Conclusion In the POAC, consultants identified a wide range of GA‐related potential problems enabling patients to be investigated, informed and prepared (or cancelled because of excess risk), and for appropriate resources to be allocated to achieve efficient and safe perioperative care.

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Section: Discussionmentioning

confidence: 99%

Paediatric pre‐operative anaesthetic clinic: A survey of consultant‐led caseload and outcomes

Chin

Macrae

Sury

2019

J Paediatrics Child Health

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“…In small children, excision often requires general anesthesia 13 . If the dermatologist considers excision necessary because of atypical features or cosmetic reasons or because the location of the nevus makes follow‐up difficult, the common practice is to wait till the patient's age allows local anesthesia 14 . Surgical complications such as scarring, infection, stretching, and dehiscence also make prophylactic excision a less attractive option 15…”

Section: Discussionmentioning

confidence: 99%

Small and Medium-Sized Congenital Nevi in Children

Roldan¹,

Hernando

Cuadrado

et al. 2009

Dermatologic Surgery

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“…Options for pain relief can be discussed and arrangements for visiting the theatre suite can be made. 6 Every child (and whenever possible his/her parents/guardian) must be seen preoperatively. 6,7 For a detailed discussion of preoperative assessment see Anaesthesia and intensive care medicine 7:10: 375.…”

Section: Preparationmentioning

confidence: 99%

“…6 Every child (and whenever possible his/her parents/guardian) must be seen preoperatively. 6,7 For a detailed discussion of preoperative assessment see Anaesthesia and intensive care medicine 7:10: 375. This assessment should always follow the structure shown in Table 2.…”

Section: Preparationmentioning

confidence: 99%