4. Inhalation Induction

Question 1

1 Indications

Answer 1

1. Parent / Patient request
   Needle phobia / repeated procedures
2. Poor / difficult venous access (chubby hands / feet)
3. ?Potential difficult airway / anticipated difficult manual ventilation
4. Foreign Body Larynx / tracheobronchial tree

Question 2

2. Contraindications

Answer 2

1 MH

2 Uncooperative parent / patient
(ethically tricky age range
urgent vs postpone w/ adequate prep)

3 Severe CV compromise
- Severe hypovolaemia / Fixed CO state / Cardiac failure / R->l Shunt

Question 3

Describe technique for performing Paediatric inhalational induction

Answer 3

1. Pre assess
   - explain + consent
   - appropriate to child’s age
2. Emergency drugs
   (Sux1-2mg/kg & Atropine 10-20mcg/kg) prepped

3 Position - Trolley or parents lap

4 Sitting lap:
Correct position parent child prior start - ease + rapidity transfer when unconscious

5. Scented facemask - hide odour of anaes
6. Some dont use mask - cup hand around tubing close to mouth/nose in younger
7. Warn parents invol movements during induction

Question 4

Inhalation

GAS

Answer 4

Inhalation is with volatile such as sevo (some use halothane)
with air or N2O depending on prefrence

Sevo can be slowly increased or start high

Halothane should be increased slowly - avoid distress

Question 5

Inhalation

Answer 5

Once unconscious
Transferred supporting head neck and body to trolley
Parents escorted from theatre by paed nurse

Now standard aagbi monitoring placed (pulse ox NIBP ECG)

Airway supported (OPA prn)

ventilated if appropriate

Venous access if sufficiently deep

Remembering decrease levels FiAnaes
when adequately anaesthetised - avoid resp/ cvs depression

Drugs given airway devices inserted