affiliates have more than 20 years experience in practice, development,
management, acquisition and turnover.
Pediatric Anesthesia Services
The approach to
anesthetic care of the pediatric patient varies widely in the United
States. In some communities, care is concentrated in specialty pediatric
hospitals or tertiary care hospitals with a commitment to pediatrics.
In other communities,
pediatric surgery and anesthesia may be distributed among many different
general hospitals and freestanding surgical centers.
surgery has such as bilateral myringotomy with tubes (BMT), adenotonsillectomy,
hemiorhapy, hydrocelectomy and orchidopexy are among the many pediatric
procedures that have been and will continue to be safely performed in
community hospitals and freestanding surgical centers. Even in these
routine procedures, it is incumbent on the anesthesiologist to be knowledgeable
about and plan for the special requirements of these pediatric patients.
pain control and potentially altered respiratory drive in the adenotonsillectomy
patient, pain control in BMT patients without intravenous access, and
control or prevention of postoperative nausea and vomiting.
Perhaps the most
difficult challenge facing anesthesiologists in these circumstances
is maintaining the technical skills necessary for safe care of pediatric
patients. Nothing can substitute for recent and continuous experience
in airway management and obtaining intravenous access in pediatric patients,
especially the very small child. Most pediatric anesthesiologist would
agree that it is not acceptable to rely on the skills of non physicians
in these areas as a matter of routine. Recognizing these limitations,
the anesthesiologists and the policy makers for the institution must
examine the local circumstances and plan accordingly. The goal is to
match the type of case to be performed with the skills of the personnel
involved. It may be appropriate in some facilities to limit the assigning
of very small or sick children to pediatric anesthesiologists
who are skilled and comfortable with the pediatric patient.
Medical Alliance, P.A.
595 South Federal Highway, Suite 250
Boca Raton, Florida 33432