"Safety in Pediatric Anesthesia" is the most recent ASA Patient Safety Videotape. It will not be distributed in the manner prior tapes have been. However, the tape is available anytime for viewing on the APSF website: https://www.apsf.org and the quality of the transmission is excellent. In addition, many of the prior videotapes are also located on the APSF website and available for viewing.
The pediatric anesthesia videotape is designed to heighten awareness in the anesthesia community of the unique risks and safety issues posed by pediatric patients. The essential components that make a perioperative environment satisfactory for the anesthesia care of infants and children are identified.
The presentation is structured around two pediatric cases: a 6-month old undergoing myringotomy tube insertion, and a neonate scheduled for a ventriculoperitoneal shunt. The unique physiology of the infant that affects anesthesia decisions, and relevant anatomic, pharmacologic and psychologic characteristics of the child are discussed. Preoperative, intraoperative, and postoperative requirements including personnel, environment, assessment, and monitoring are described in detail for each case.
Each of the following elements involved in the preparation of a safe pediatric perianesthesia environment is reviewed:
- identification of necessary equipment
- identification of policies and procedures for commonly occurring challenges
- identification of the patient that can properly be cared for in a given institution
It is concluded that each institution must assess its own capabilities and limitations, establish criteria for admission and transfer of pediatric patients, and establish clear guidelines for proper pediatric perianesthesia care.
Recommendations are based on the Standards and Guidelines of the American Society of Anesthesiologists as well as on Guidelines for the Pediatric Perioperative Anesthesia Environment published in 1999 by the American Academy of Pediatrics.
"Safety in Pediatric Anesthesia"
Ellison Pierce, Jr, MDChairman Emeritus, Department of AnesthesiaNew England Deaconess HospitalBoston, Massachusetts
Francis X. McGowan, MD Children’s Hospital and Harvard Medical School Boston, Massachusetts
Joseph R. Tobin, MD Wake Forest University School of Medicine Winston-Salem, North Carolina
Steven C. Hall, MD Children’s Memorial Hospital Chicago, Illinois
Mark A. Rockoff, MD Children’s Hospital and Harvard Medical School Boston, Massachusetts
Patrick J. Donahue, MD Saints Memorial Medical Center Lowell, Massachusetts
Mark Singleton. MD
Los Angeles, California