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AAP: Communication key when preparing children, families for anesthesia
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A recent policy statement from the AAP discusses how pediatricians can prepare children and families for surgery that requires anesthesia and how to optimize care during surgery.
The first step in preoperative preparation is to ensure that patients are in the best state of health when they present to the operating room. Providers should be cognizant of patients’ medical conditions and any concurrent acute illnesses that may need to be managed. Patients’ medical conditions should be “optimized” during surgery.
The second step is to educate patients’ family about the procedure and establish a process the family is comfortable with for their child.
There is no standard procedure for preparing children for surgery, as resources vary among institutions. Options include Web-based information, tours of the perioperative environment, coping and relaxation instruction, and interventions by child life specialists. Another option used by some hospitals is parental presence during induction of anesthesia (PPIA). However, PPIA is not a universal practice and should always be at the discretion of the anesthesiologist.
Children with complex medical or surgical conditions may benefit from a thorough preoperative assessment from an anesthesia care provider. Many anesthesia departments have consultation clinics that provide a common touch point for all parties involved in the surgical procedure. If no such clinic is available, then the anesthesiologist should address any questions the pediatrician or family may have.
The policy statement addresses how providers should manage children with various comorbidities before anesthesia, including children with cardiac disease, hematologic or oncologic disorders, diabetes, respiratory disorders, central nervous system disorders, former preterm infants and more.
“Pediatricians are in a unique position to help prepare children and their families for surgery and help the perioperative team optimize care. Communication about conditions related to increased risk in the operating room and aiding the family to advocate for their child in a stressful situation are valuable contributions to the perioperative preparation of the pediatric patient,” the policy statement concluded.
Disclosure: The researchers report no relevant financial disclosures.
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