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Anesthetic management of common pediatric emergencies

Andrew Davidson1

  • 1Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia. andrew.davidson@rch.org.au

Current Opinion in Anaesthesiology
|April 9, 2013
PubMed

Insights

Pediatric anesthesiologists face challenges in managing emergencies due to limited evidence. Key 2012 publications highlight controversies in airway management and gastric volume assessment, with emerging concerns about postoperative pain.

Area of Science:

  • Anesthesiology
  • Pediatric Emergency Medicine
  • Critical Care

Background:

  • Pediatric emergency management requires up-to-date knowledge.
  • Limited high-quality evidence exists for many pediatric emergencies.

Purpose of the Study:

  • Identify key 2012 publications relevant to anesthetic management of pediatric emergencies.
  • Provide current insights for pediatric anesthesiologists.

Main Methods:

  • Literature review of publications from 2012.
  • Analysis of multi-institutional audits and studies on common pediatric emergencies.

Main Results:

  • Tracheo-esophageal fistula management shows varied anesthesia practices and ventilation difficulties.
  • Bronchoscopy for foreign bodies demonstrates effective practices with low complications.
  • Postoperative pain is a significant concern after common procedures, including emergency surgery.
  • Ultrasound for gastric volume assessment is promising but unproven.
  • Resuscitation guidelines have been updated.
  • Anesthetic approach for pediatric brain injury is evolving despite weak evidence.

Conclusions:

  • Many pediatric emergency management areas lack robust evidence.
  • Despite limited evidence, complication rates remain low.
  • Postoperative pain is an emerging issue.
  • Optimal management of the full stomach in pediatric patients is unresolved.
Abstract

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