Near Misses in Pediatric Anesthesia Second Edition PDF Download
Near Misses in Pediatric Anesthesia Second Edition – Anesthesia is always an Evergreen Field which is always an Extra care Efforts to recover and Sedate the Patient and understanding of each and every concepts to Gain the Concepts of Caring and Preoperative care.
Near Misses in Pediatric Anesthesia Second Edition
General anesthesia is induced via face mask using sevofl urane 1–4 % in nitrous oxide and 30 % oxygen after all necessary monitoring equipment is placed on the child. After the child is asleep, an intravenous (IV) line is inserted, and 0.15 mg atropine and 1.6 mg vecuronium are administered to facilitate tracheal intubation with a 5-mm internal diameter (i.d.) tracheal tube. Breath sounds are equal bilaterally, and a leak around the tube in the trachea is present at 20 cm H 2O peak inflation pressure.
The endotracheal tube (ETT) is securely taped. The patient’s lungs are hand ventilated using peak inspiratory pressures of 15–35 cm H 2O. The patient is draped from the neck down, and the endoscopist places the gastroscope into the esophagus without diffi culty. A few minutes later, the lungs become less compliant, and the child’s blood pressure (BP) decreases over a 5-min period from 90/50 to 70/35 mmHg.
The electrocardiogram (ECG) is judged to be normal, and the heart rate increases from 110 to 130 beats per minute [ 1] (bpm) with a regular sinus rhythm. The capnograph demonstrates a CO 2 waveform. The shape has not changed; however, the peak airway pressure now increases from 22 to 38 cm H 2 O. The peripheral oxygen saturation decreases from 100 % to 86 %.