cific rooms for pediatrics? Have cartoon characters on the wall.
Bright colors. Familiar music in the background. Once the child and
parent enter the OR, turn your full attention to them: no counting of
instruments and OR-talk. The child is the most important person in
the room. Treat him with respect and dignity. Maintain eye contact.
Speak to him. Give him choices whenever possible. Ask, "Would you
like to sit up on the table or on Mom's (or Dad's) lap?" "Which finger
do you want the finger-sticker on?" "Do you want to hold the mask?"
Then prepare for induction. Once the anesthesia circuit is primed
with nitrous, let the child assist you. Have him hold the mask with you.
If he resists the mask, gently hold his hands at his side and sing a song
as the anesthetic is dialed in. You could also try an anesthesia induction
device. A number of mask-based distraction devices have been created
over the years, including a maskless device I've developed (see "CRNA
Develops Maskless Induction Device" on page 22).
Are you kid-friendly?
Pediatric induction has remained unchanged for decades. Just lay the
child on the OR table, place the anesthesia mask over his nose and
mouth, turn on the oxygen-gas admixture, then watch as he gently
drifts off to sleep. Sounds simple, but as we know, it can be downright
scary for kids and their parents. With the push for greater consumer
satisfaction in health care, strive to make your facility kid-friendly.
OSM
Ms. Miller (pediallc@gmail.com) is the CEO and inventor of PeDIA, a pedi-
atric device for induction of anesthesia.
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