Term 5 Week 3 (w/c 28/01/13)
Thankyou to everyone who has contributed to the discussions so far. Once again we have kicked off the term with strong numbers of hits on the blog site.
For this weeks case you are working as the resident in a large teaching hospital. It is evening time and you have been told about a neonate that is being transferred into the hospital from a different unit.
The history suggests that the child may have a tracheooesphageal fistula?
How has this child likely to have presented? We will add an additional question later today when we have had some responses
The child has now arrived in the hospital. What information will you be looking for during pre assessment of this neonate?
You visit the patient on the neonatal care unit. They had an uneventful vaginal delivery 17 hours ago. Gestationally they were born at 39+2 weeks with the only antenatal concern being polyhydramnios.
The child weighs 2.2KG and there are no associated anomalies (including cardiac)
The first signs of problems where during feeding when there was coughing and an episode of cyanosis. Feeding was ceased and a CXR showed a radio opaque catheter coiled in the oesophageal pouch and a large air bubble below the diagphram. Currently there is no respiratory distress.
What are the basic principals for anaesthetising this child. Do not feel you have to explain the whole process in one go but hopefully we can work through the basics and form a sensible plan…
Thanks to everyone for a productive and informative discussion so far this week. This is obviously a case for experts and not for amateurs but hopefully everyone can learn something?
Assumind the child has been induced and positioned correctly in theatre. Surgery has proceeded uneventfully.
What are the options for post operative analgaesia in this child? Where will the child go post op?
There are no trick questions in #Gasclass. Everyone’s contribution is welcome. Please do not forget to add the ‘hashtag’ #gasclass to every Tweet so that it is included in the conversation. To help give new contributors an opportunity to join in we would advise that you should only add one ioperativedea per tweet and not contribute until another Tweeter has joined in.
New style summary for this weeks discussion. Tweet us @gasclass to let us know your thoughts here