Schedule/Cancel the surgery...

The dicision whether to proceed with surgery in any child with URTI requires careful risk/benefit analysis on an individual basis and is summarized in the table below.

Schedule	Cancel
Clear runny nose	Child < 1 yr
Dry cough	Purulent nasal discharge
Minor surgery	Productive cough
	Wheezing/crepitations on auscultation
	Systemic features of being unwell, i.e. fever>38, malaise, headache, feeding problems
	Parental confirmation of child being unwell

Also consider patient co-morbidities, type or urgency of surgery, and experience of anaesthetist.

Comments

The pressure volume loop...

In the pressure-volume loop below, cardiac work is best represented by: the area of the curve the slope of the line from points C to D the distance of the line from points C to D the slope of a line from points A to D .. .. ... .... ... .... .... .... In the pressure-volume loop below, cardiac work is best represented by: the area of the curve Cardiac work is the product of pressure and volume and is linearly related to myocardial oxygen consumption. Cardiac work is best represented by the area of the curve of a pressure-volume loop.

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Anaphylaxis updates part 2- Empty Ventricle Syndrome

Patients with anaphylaxis should not suddenly sit, stand, or be placed in the upright position. Instead, they should be placed on the back with their lower extremities elevated or, if they are experiencing respiratory distress or vomiting, they should be placed in a position of comfort with their lower extremities elevated. This accomplishes 2 therapeutic goals: 1) preservation of fluid in the circulation (the central vascular compartment), an important step in managing distributive shock; and 2) prevention of the empty vena cava/empty ventricle syndrome, which can occur within seconds when patients with anaphylaxis suddenly assume or are placed in an upright position. Patients with this syndrome are at high risk for sudden death. They are unlikely to respond to epinephrine regardless of route of administration, because it does not reach the heart and therefore cannot be circulated throughout the body

sedationstation

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