Outpatient Surgery Magazine - Subscribers

Shopping for Surgery - June 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/527397

Contents of this Issue

Navigation

Page 49 of 162

LMA into position. You can also insert them with the cuff partially or fully deflated, or with the aperture facing posterior, and then turned 180 degrees after passing behind the tongue. Putting water-based lubricant on the posterior surface decreases resistance. There may be some pharyn- geal bleeding with LMAs, and some children may end up with sore throats, but those are less common than they are after endotracheal intu- bation. Laryngoscopy is also relatively straightforward and technically easy in most children 2 or older, because the glottis is usually easy to see in children. But in neonates and small infants, laryngoscopy can be chal- lenging, because the anesthesiologist's optimal position differs from that of adults. The line of sight should be nearly directly over the child's airway, and to gain the easiest view of the glottis, insert the blade more perpendicular to the OR table than with older children or adults. Tracheal intubation Unless I have to, I try not to intubate or use a laryngoscope. But when nec- essary, tracheal intubation is straightforward, unless the child has altered facial or airway anatomy. If you anticipate a difficult intubation, I advise against attempting direct laryngoscopy. Each unsuccessful direct attempt 5 0 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2 0 1 5 DENTAL CHECKUP Any Loose, Chipped Teeth? After induction of general anesthesia, but before airway instrumentation, check for loose or chipped teeth and remove primary teeth that are very loose. Grasp the tooth firmly with gauze and rock it back and forth while pulling or twisting. You can stop minor bleeding with firm pressure. And all personnel in attendance should be required to contribute to the tooth fairy fund. — Ronald S. Litman, DO

Articles in this issue

Archives of this issue

view archives of Outpatient Surgery Magazine - Subscribers - Shopping for Surgery - June 2015 - Outpatient Surgery Magazine