Anesthesia effects on children - PowerPoint Presentation

Slide1

Anesthesia effects on children

By: Hunter, Erin, Marc, Elise, and Alexis Slide2

Introduction

A nurse anesthetists responsibilities is to assess the patient before administering medication and producing a plan to recommend what medication should be given and the amount. Must give notes after the procedure to the post op team

The medications given have an effect on the child relating to their oxygenation throughout the procedure

Vital signs must be monitored throughout the procedure to ensure the patient is stableSlide3

Pico Question

How does anesthesia effect a child in surgery?

Population: Children

Intervention: anesthesia medication

Comparison: type of medication & amount given

Outcome: patient has successful outcome after surgery Slide4

Nursing Research: Article

“Effects of Anesthetic Agents on Blood Brain Oxygenation Level Revealed with Ultra-high Field MRI”

Done because of conflicting results with Ketamine

Why use an MRI?

Done on rats

isoflurane

, ketamine-

xylazine

, and

medetomidine

How is this related to a nurse anesthetist’s job?Slide5

Psychology research: propofol

Background

First

used in 1977

Approved by FDA in 2008 Brand name is DiprivanSlide6

Psychology research: Propofol

uses and side effects

Side effects

- Pain at injection site

Seizure

Weak and shallow breathing

Uses

- Surgery

- Medical exams

Patients on ventilators

Sedation during MRI’s Slide7

Psychology research: Half life of propofol

Slide8

Psychology Research: Anesthesia use in the Pediatric

icu

Objective

: Evaluate

Propofol

anesthesia delivered to

pediatrics in a

PICU who

undergo oncology

procedures Testing: They studied fifty procedures on 28 pediatric patients ranging from 3 to 12 years old. The study recorded the time the patient entered the PICU, the time anesthesia administration, procedure start and end time, recovery time and discharge time.Slide9

Psychology Research: Results

Time in Minutes

Phase (Mean [+ or -] SD)

Admit

to PICU to the start of

24.6 [+ or -] 9.9

Anesthesia

Start of anesthesia till

1.5

[+ or -] .7

anesthetized (Induction Time)

Anesthetized to the start of

5.9 [+ or -] 2.6

Procedure

Start of procedure to the end of

14.3

[+ or -] 11.3

procedure (procedure time)

Anesthesia end time till awake

23.4

[+ or -] 11.5

(recovery time)

Awake till discharge from PICU

23.5 [+ or -] 17.5

Length of stay

88.8

[+ or -] 27.7

 Slide10

Psychology research: versed

Also known as Midazolam

Falls in the category of benzodiazepines

Often combined with FentanylSlide11

Versed uses and side effects

USES

Procedures that do not require general anesthesia

“Twilight sleep”

In ICU to induce a “coma”

SIDE EFFECTS

Respiratory depression

Tachycardia or bradycardia

Swelling

Nausea Slide12

midazolam vs. propofolSlide13

Nursing Theory

Sr.

Callista

RoySlide14

Cognitive theory : Jean piaget

Ranges from infancy to adolescent

-

Stages:

Sensorimotor (birth- two

years)

Preoperational (2-7 years

)

Concrete operational (7-11 years

) Formal Operational (11- older)Slide15

Major Research findings

Medications can affect people in several different ways and it is really important to know what medication is right for your patient.

Propofol

is a commonly used anesthetic due to its relatively low risk factor and short half life which allows the patient to be awake with little or no side effects in little as 20 minutes from the end of administration.

Versed, or Midazolam has a slower onset than other drugs, but when it is carefully combined with other anesthetics it can be highly effective in providing ideal comfort for a patient.

There are many ways to use

Sr Callista Roy's Adaptation Model. It can be applied to the disease process, new diagnoses and day to day nursing care. Every person might react differently to drugs no matter what age but younger people are more likely to have a reaction due to the brain not fully developed Slide16

Concept map

Anesthesia Effects

Health Promotion

-Educating the patient on the possible side effects before surgery

-Educate the patient on how to have a safe recovery

Ethics

Do not give patient medication faster than recommended time

- Always check drug compatibility

Diversity

-medication effects everyone differently

Lifespan consideration

-different dosages based on weight and age

- Monitor infants and elderly more frequently

Resources

Consult another nurse about drug

Consult with anesthesiologist

Research

Leadership

Main caregiver during surgery

Researching the best drug and does

Information Systems

Access to latest drug studies

Document all findings

Review patient history Slide17

Clinical implication

Asses the patient before administering medication

Brain damage could be caused

Patient comfort during surgery

Make sure the patient receives the correct dosage Slide18

Conclusion Slide19

References

Taylor, C. (2011). Theory, Research, and Evidence-based practice. 

Fundamentals of nursing: the art and science of nursing care

(7th ed., ). Philadelphia:

Wolters

Kluwer Health/Lippincott Williams & Wilkins.

Roy's Adaptation Model. (2013, September 9).

Roy's Adaptation Model

. Retrieved April 20, 2014, from

http://currentnursing.com/nursing_theory/Roy_adaptation_model.html

Anderson, B. D., Dalton, H. J.,

Gootenberg

, J. E., Hauser, G. J., Hertzog, J. H., &

Shad

, A. T. (2000, October). Prospective Evaluation of

Propofol

Anesthesia

in the

Pediatric Intensive

Care Unit for Elective Oncology

Procedures

in Ambulatory and Hospitalized Children.

Pediatrics

,

106

(4),

742

. Retrieved from http://

go.galegroup.com/ps/i.do?id=GALE%7CA66665100&v=2.1&u=lom_ferrissu&it=r&p=AONE&sw=w&asid=610dc4b08a1e1ed899bcd420eb

220e9a

Propofol

Official FDA information, side effects and uses.. (March, 2003).

Propofol

Official

FDA information, side effects and uses.

. Retrieved April 24, 2014,

from http

://www.drugs.com/pro/propofol.html

Diprivan

(

Propofol

) Patient Information: Side Effects and Drug Images at

RxList

.

(

n.d.

).

RxList

. Retrieved April 24, 2014, from

http

://

www.rxlist.com/diprivan-

drug/patient- images-side-effects.htm

Ciobanu

L, Reynaud O,

Uhrig

L,

Jarraya

B, Le

Bihan

D (2012) Effects of Anesthetic Agents on Brain Blood Oxygenation Level Revealed with Ultra-High Field MRI.

PLoS

ONE 7(3): e32645. doi:10.1371/journal.pone.0032645

Lamdin

, R., & Shaw, S. (2011, August). Nurses have an ethical imperative to minimize procedural pain. Kai

Tiaki

: Nursing New Zealand, 17(7), 12+. Retrieved from

http

://

go.galegroup.com/ps/i.do?id=GALE%7CA266344840&v=2.1&u=lom_ferrissu&it=r&p=AONE&sw=w&asid=2e190fb6b16b1538a38842d1d854e7c

Taylor, C., Lillis, C.,

LeMone

, P., & Lynn, P. (2011).

Fundamentals of nursing: The art and

Science

of nursing

care

(7th ed.).

Philadelphia, PA: Lippincott Williams &

Wilkins.364

.

The

blood supply of the brain and spinal cord (2001).

National Center for Biotechnology.

Retrieved from

http://www.ncbi.nlm.nih.gov/books/NBK11042/

Slide20

More References

(

2013).

Medazolam

.

Drugs.com.

Retrieved from

http://www.drugs.com/cdi/midazolam.html

Aoki, K.,

Gokan

, D., Hirose, N., Iwasaki, K., Kato, J., Ogawa, S., Ogawa, Y. (2010). The Different Effects of Midazolam and

Propofol

Sedation

on Dynamic

Cerebral

Autoregulation

.

Anesthesia & Analgesia, 111

(5). Retrieved from

http://journals.lww.com/anesthesia-

analgesia/

Fulltext

/2010/11000/The_Different_Effects_of_Midazolam_and_Propofol.30.aspx

Heisler

, J. (2014). Versed (

Medazolam

).

About.com Surgery.

Retrieved from

http://surgery.about.com/od/beforesurgery/qt/VersedMidazolamVersed.htm

Roth, M. (2011). Parasympathetic Nervous System Dominance.

Dr. Michael Roth’s Weblog.

Retrieved from

http://drmichaelroth.wordpress.com/2011/08/03/parasympathetic-nervous-system-dominance/

Roth, M. (2011). Sympathetic Nervous System Dominance.

Dr. Michael Roth’s Weblog.

Retrieved from

http://drmichaelroth.wordpress.com/2011/07/05/sympathetic-nervous-system-dominance/