#1 – Pediatrics: Are They Just Little Adults? – Walter Rose, D.O.

Dr Walter Rose, D.O., attending anesthesiologist at Kosair Children’s Hospital, discusses the specific attributes that make caring for pediatric patients unique as anesthesia providers.  Dr Rose is the Director of Pediatric Cardiac Anesthesia at Kosair Children’s Hospital and also serves as an Assistant Professor of Anesthesiology with the University of Louisville School of Medicine.  He is a Diplomate of the American Board of Anesthesiology.

A quick overview of how pediatrics differ from adults.

•Hypothetical Patient HR 190, BP 60/30, RR 60, HGB 19, WBC 30,000, K 7.5, NA 160.  Is you patient in trouble?

•It depends because these are all normal values from a New Born.

•Commonalities between adults and kids.

•Same Species
•Same Basic Anatomy
•Generally use the same Anesthetic techniques
•Generally use the same Pharmacological agents
•Anesthesia Goal are the same
•Sometimes the case is done the exact same as an Adult

•Differences between Pediatrics and Adults.

•Things tend to happen quicker in pediatrics
•Kids desaturate more quickly and they will resaturate more quickly
•Pediatric baseline heart rate is usually faster
•Takes more finesse to work with pediatrics
•Pediatrics have smaller airways, smaller veins, ect…
•Physiology is different especially in newborns
•More unique surgical procedures, such as a congenital diaphragmatic hernia repair
•Pediatric Anatomy is slightly different from adults, therefore miller blade used more
•Psychological concerns are different at different ages
•Also must deal with the parents psychological concerns
•NPO guidelines are shorter in pediatrics

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