Questions and Answers
What is the primary reason why children require closer monitoring of blood loss during surgery?
Why would the surgeon request special blood tests preoperatively?
What is the equivalent volume of blood that a seven-pound baby can afford to lose before requiring a blood transfusion?
Why is it important to ensure the child's respiratory tract is unobstructed before administering a general anesthetic?
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Why do children need to eat frequently?
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What is one reason that infants are allowed to be fed closer to surgery time compared to adults?
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Why is it important to consider the size and selection of surgical instruments for pediatric surgery?
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What scheduling practice is common for pediatric surgeries compared to adult surgeries?
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What is the main concern when interrupting an infant's feeding schedule before surgery?
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What factor determines the timing of the last feeding before surgery for infants?
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Study Notes
Pediatric Surgery Considerations
- Children have a smaller circulating blood volume compared to adults, making it critical to monitor blood loss during surgery to avoid shock.
- A 7-pound baby has a blood volume of approximately 250-350 ml, and can only afford to lose 10% of that (25-30 ml or roughly 1 ounce) before requiring a blood transfusion.
- The circulator and scrub must closely monitor wound suction container and irrigation fluids used to accurately track blood and fluid loss.
- Bloody sponges should be weighed to keep an accurate accounting of total blood and fluid loss.
Preoperative Considerations
- The surgeon may request special blood tests preoperatively to determine the child's blood clotting time and potential bleeding problems.
- It is crucial to identify any bleeding disorders, such as hemophilia, before surgery to ensure proper preparation.
Anesthesia and Respiratory Considerations
- Children are more susceptible to respiratory infections and pneumonia due to their underdeveloped immune systems.
- General anesthesia is commonly used in pediatric surgery, and it is essential to ensure the child's respiratory tract is unobstructed.
- If a child has "sniffles" or sounds congested, it may be risky to administer general anesthesia, and the OR nurse or anesthesia staff should be informed.
Nutrition and Feeding Schedules
- Infants and children require frequent feeding to provide them with energy for growth and development.
- It is essential to minimize interruptions to the feeding schedule to avoid weakening and dehydrating the infant, which increases the risk of surgery.
- Infants may be fed up to a couple of hours before surgery, and the time of the last feeding is based on the age of the infant or child and the scheduled surgery time.
Instrument and Suture Selection
- Pediatric surgery requires special attention to instrument and suture selection, as well as surgical draping material and positioning techniques, due to the smaller size of infants and children.
- Adult-sized instruments, sutures, drapes, and positioning devices are not suitable for pediatric patients.
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Description
Quiz on blood volume differences between children and adults, and their implications for surgery and blood transfusions. Understanding the importance of blood volume in pediatric patients.
