Perioperative Care of the Child: A Nursing Manual

Contributors

Introduction

Acknowledgements

Abbreviations

1 The history of children’s perioperative care – Jeremy Jolley

Why history is important

What is perioperative nursing?

A brief history of perioperative nursing

An overview of the history of surgery

The development of perioperative nursing

Key discoveries in perioperative care

Early beginnings of surgery for children

The growth of paediatric surgery

Conclusion: perioperative nursing of children

References

2 The psychosocial care of children in the perioperative area – Linda Shields

Children’s perceptions of the operating theatre

The effect of hospitalisation on children

Models of care

The presence of parents

Play in the operating theatre suite

Emotional, social and spiritual needs of the patient

Conclusion

References

3 Care of the child in the operating room – Linda Shields and Ann Tanner

Preparation of children for theatre

Admission prior to surgery

Observation

Weight

Surgical history

Medical history

Medications

Body/site preparation

Pre-admission clinic

Emergency admission

Day of surgery admission

Reception in the operating suite

Registration on entrance to the OR

Fasting

Other things to check on admission to the OR

Safety of children in the operating theatre

Specific safety issues for children during induction

Post anaesthetic/post operative

Standing orders

Conclusion

References

4 Nursing care and management of children’s perioperative pain – Bernie Carter and Denise Jonas

Introduction

Preparing and teaching children and parents about pain

Agency, education and training of health care professionals

Assessing children’s pain

Core approaches to pain assessment

What tools to consider using with particular groups of children

Non-pharmacological interventions

Overview of pharmacological intervention

Routes of administration

Other local anaesthetic infusions

Discharge home

Conclusion

References

5 Surgical procedures on children – Linda Shields and Ann Tanner

Introduction

Common surgical procedures performed on children

Acknowledgement

References

6 Day surgery for children – Ann Tanner

Day procedure centres

Pre-admission preparation

Admission to the day procedure centre: preparations for surgery

Compartment syndrome

Admission to theatre

Ward stage recovery: post-operative care

Conclusion: support at home

References

7 Anaesthesia in children – Wendy McAlister

Introduction: What is anaesthesia?

The anaesthetic nurse

Children undergoing anaesthesia

Anaesthetic equipment

Airways

Anaesthesia

Analgesia

Patient preparation

Fasting

Premedication

Loose teeth and nail polish

Hearing aids and glasses

Jewellery

Preparation prior to patient arrival

Patient arrival in theatre

Induction

Rapid sequence induction

Fluids

Monitoring

Documentation

Anaesthetic emergencies

Anaphylaxis

Suxamethonium apnoea

Malignant hyperthermia

Emergence

Regional anaesthesia

References

8 The paediatric post-anaesthetic care unit – Eunice Hanisch

Introduction

In the PPACU

The post-operative environment

Oxygen delivery

Suction

Physiological assessment and management of the paediatric post-anaesthesia patient

A – Airway management and B – Breathing

Respiratory complications and nursing interventions

C – Circulation

Thermoregulation and temperature abnormalities

Post-operative nausea and vomiting

Pain management in the PPACU

Infection control

Fluid and electrolyte balance

Wounds and dressings

Patient positioning

Latex allergy

Children with epilepsy

Delayed emergence

Emergence delirium

Discharge of the patient from the PPACU

Psychological assessment

References

9 Fetal surgery – Roy Kimble

Introduction

History

The risks of fetal surgery

Fetal conditions amenable to fetal surgery

Ex utero intrapartum treatment (EXIT)

The future

References

10 Perioperative care of children with burns – Roy Kimble and Julie Mill

Introduction

History

Epidemiology of burns in children

A multidisciplinary service approach

Clinical assessment of burn severity

A – Airway

B – Breathing

C – Circulation

D – Neurological disability

E – Exposure with environment control

Classification of burn depth

Determination of burn depth

Laser Doppler scanning

Electrical burns

Chemical burns

Calculation of burn surface area

Management

Burn wound care

Preparation for theatre

Pain management via acute pain service

Post-operative care

Physiotherapy

Infection control

Toxic shock syndrome

Tetanus

Human immunodeficiency virus (HIV)-positive children

Scar management

Discharge planning

References

11 Paediatric transplantation – Rebecca Smith and Susan Tame

Introduction

Becoming an organ donor

Types of donation

Role of the transplant co-ordinator

Donor care and management

Making the donation request

Preoperative care of a potential paediatric donor

Perioperative care

Recipient management and care

Cardiothoracic organs

Immediate post-operative care

Liver

Kidneys

Small bowel, liver and multivisceral

Reducing the risk of rejection of the new organ

Longer-term post-operative care

The future

References

Further reading

12 The care of children having endoscopic procedures – Janet Roper and Linda Shields

Introduction

The perioperative nurse’s role

Preparing children for endoscopic procedures

Perioperative care

Service perspectives

Equipment for MIS and endoscopy

Conclusion

References

13 Ethical and legal issues in paediatric perioperative care – Linda Shields

Patients’ rights

Self-determination

Privacy

Confidentiality

Consent

Legal perspectives

Medical futility

Conclusion

References

Index