peads anesthesia

EMLA cream : Eutectic mixture of local anesthetics : prilocaine and lignocaine

prilocaine S/E Methemoglbinemia and antidote for it is methylene blue

anxiolysis :

IM ketamine: might increase secretions so will need atropin or glycopyrolate

fentanyl lollipop

peads airway : anatomic differences

small trachea

prominent occiput problem positionin

high airway resistance due to smaller passaged

large tongue

large epiglottis

fragile tracheal cartilages

funnel shaped cricoid cartilage narrowest

anterior larynx

small oral cavity

physiologic differecnes :

less FRC alveoli are fragile compliance is less ribs are horizontal

high oxygen consumption in children 7-8 ml/kg. less in adults: 3-4ml/kg

less sympathetic stimulation in response to hypoxia, less chemoreceptors

interroseous

use of usg and vein visualiser

cuffed tube better than uncuffed but put less pressure in cuff about 25mmhg which is less than capillary
pressure 30mmhg otherwise will cause subglottic edema ( Rx. steroids and adrenaline racemic
epinephrine, heliox mixture

to check cuff pressure use manometry or air leak test and put throat pack
problems with throat pack : sore throat, leaving it in.

it should be radioopaque and lubricate it and put it under vision

broncospasm

less developed sympathetic system: prefer ipratropium is anticholinergic so preferred compared to

salbutamol.

magnesium

lidocaine

ECMO

ketamine avoided as it will imcrease secretions