11 Questions
Which of the following is NOT a common difference in the airway of infants compared to adults?
The epiglottis projects anteriorly
Which type of laryngoscope blade is preferred for infants?
Straight blade
What is the acceptable percentage of total body water loss in infants?
10%
Which of the following fluid combinations would be considered normotensive for infants?
0.45% saline with 5% dextrose
Which of the following factors increases the risk of hyponatremia and encephalopathy in infants and children?
High brain/skull ratio
Which of the following is NOT a reason why infants have poor thermal control?
Smaller surface area to weight ratio
Which of the following is NOT a recommended measure for maintaining temperature in infants during surgery?
Cooling respiratory gases
What percentage of an adult's surface area is the head?
9%
Which of the following is NOT mentioned as a measure for maintaining temperature in infants during surgery?
Using a heated mattress
When is direct warming needed for infants during surgery?
For lengthy operations
Which of the following is a reason cited for infants having poor thermal control?
Greater heat loss from respiration
Study Notes
Pediatric Surgery
- Infants have a larger head and shorter neck, making them prone to flexion.
- The larger tongue can obstruct the airway when the infant is unconscious, making laryngoscopy more difficult.
- The epiglottis projects posteriorly and the larynx is high in infants.
Airway Differences
- Straight bladed laryngoscope is favored in infants due to differences in airways compared to adults.
- Infants are more susceptible to hyponatremia and its subsequent encephalopathy due to their high brain-to-skull ratio.
Perioperative Fluid Management
- Hyponatremia can occur when giving hypotonic maintenance fluid (0.18% saline) or when excess fluid is given.
- Normotensive fluids for infants include 0.18% saline with 4% dextrose or 0.45% saline with 5% dextrose.
Maintaining Temperature
- Infants have poor thermal control due to less subcutaneous fat, greater heat loss from respiration, a higher surface area-to-weight ratio, and immature vasomotor control.
- To maintain temperature, provide a warm environment, insulate the infant's head, warm infusions, use warm and humidified respiratory gases, monitor core temperature, and use direct warming for lengthy operations.
Test your knowledge on the principles of pediatric surgery with this quiz. Learn about the clinical differences between adults and children, maintaining temperature and airway, and safely prescribing perioperative fluids.
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