Perioperative Care of the Child: A Nursing Manual

Perioperative Care of the Child Edited by well-known and highly-regarded children’s nurse Linda Shields, Perioperative Care of the Child is an essential resource for any children’s nurse working in a perioperative setting and all student nurses on the child branch. This timely and valuable text provides comprehensive coverage of the essential skills and knowledge required by practitioners in order to deliver safe and effective perioperative nursing care for the child requiring surgery before, during and after any operation. Perioperative Care of the Child explores the role of the nurse in a wide variety of perioperative contexts, including anaesthetics, surgical procedures (including coverage of fetal surgery, endoscopic procedures and care of children with burns), paediatric transplantation, postoperative recovery, and pre- and post-hospital care. This essential resource benefits from an international perspective, with contributions from experienced and highly-specialised clinicians from around the world. Essential reading for children’s and perioperative nurses, and others who work in the perioperative area. Evidence-based, with clear links to nursing practice. Focuses on key skills and knowledge. Emphasises patient-centred care. Edited by an internationally-regarded children’s nurse.

Table of Contents:
Contributors ix Introduction xi Acknowledgements xiii Abbreviations xiv                                                                                                                                                                                                                                                                                                            1 The history of children’s perioperative care – Jeremy Jolley 1 Why history is important 1 What is perioperative nursing? 1   A brief history of perioperative nursing 2 The development of perioperative nursing 5 Key discoveries in perioperative care 6 Early beginnings of surgery for children 7 The growth of paediatric surgery 9 Conclusion: perioperative nursing of children 10 References 11 2 The psychosocial care of children in the perioperative area – Linda Shields 13 Children’s perceptions of the operating theatre 13 The effect of hospitalisation on children 14 Models of care 16 The presence of parents 19 Play in the operating theatre suite 20 Emotional, social and spiritual needs of the patient 20 Conclusion 21 References 21 3 Care of the child in the operating room – Linda Shields and Ann Tanner 23 Preparation of children for theatre 23 Admission prior to surgery 24 Observation 25 Weight 25 Surgical history 25 Medical history 25 Medications 27 Body/site preparation 27 Pre-admission clinic 27 Emergency admission 28 Day of surgery admission 29 Reception in the operating suite 30 Registration on entrance to the OR 31 Fasting 31 Other things to check on admission to the OR 32 Safety of children in the operating theatre 33 Specific safety issues for children during induction 33 Post anaesthetic/post operative 34 Standing orders 36 Conclusion 37 References 37 4 Nursing care and management of children’s perioperative pain – Bernie Carter and Denise Jonas 39 Introduction 39 Preparing and teaching children and parents about pain 41 Agency, education and training of health care professionals 42 Assessing children’s pain 43 Core approaches to pain assessment 44 What tools to consider using with particular groups of children 46 Non-pharmacological interventions 46 Overview of pharmacological intervention 47 Routes of administration 48 Other local anaesthetic infusions 55 Discharge home 55 Conclusion 56 References 56 5 Surgical procedures on children – Linda Shields and Ann Tanner 66 Introduction 66 Common surgical procedures performed on children 66 Acknowledgement 96 References 96 6 Day surgery for children – Ann Tanner 101 Day procedure centres 101 Pre-admission preparation 105 Admission to the day procedure centre: preparations for surgery 105 Compartment syndrome 112 Admission to theatre 112 Ward stage recovery: post-operative care 113 Conclusion: support at home 116 References 116 7 Anaesthesia in children – Wendy McAlister 119 Introduction: What is anaesthesia? 119 The anaesthetic nurse 119 Children undergoing anaesthesia 120 Anaesthetic equipment 121 Airways 124 Anaesthesia 127 Analgesia 130 Patient preparation 130 Fasting 130 Premedication 131 Loose teeth and nail polish 131 Hearing aids and glasses 132 Jewellery 132 Preparation prior to patient arrival 132 Patient arrival in theatre 133 Induction 133 Rapid sequence induction 135 Fluids 135 Monitoring 135 Documentation 136 Anaesthetic emergencies 136 Anaphylaxis 138 Suxamethonium apnoea 138 Malignant hyperthermia 139 Emergence 139 Regional anaesthesia 140 References 141 8 The paediatric post-anaesthetic care unit – Eunice Hanisch 144 Introduction 144 In the PPACU 144 The post-operative environment 147 Oxygen delivery 149 Suction 151 Physiological assessment and management of the paediatric post-anaesthesia patient 151 A – Airway management and B – Breathing 151 Respiratory complications and nursing interventions 152 C – circulation 155 Thermoregulation and temperature abnormalities 156 Post-operative nausea and vomiting 160 Pain management in the PPACU 164 Infection control 165 Fluid and electrolyte balance 166 Wounds and dressings 168 Patient positioning 168 Latex allergy 169 Children with epilepsy 170 Delayed emergence 170 Emergence delirium 171 Discharge of the patient from the PPACU 171 Psychological assessment 172 References 175 9 Fetal surgery – Roy Kimble 179 Introduction 179 History 179 The risks of fetal surgery 180 Fetal conditions amenable to fetal surgery 181 Ex utero intrapartum treatment (EXIT) 183 The future 184 References 184 10 Perioperative care of children with burns – Roy Kimble and Julie Mill 185 Introduction 185 History 185 Epidemiology of burns in children 186 A multidisciplinary service approach 187 Clinical assessment of burn severity 188 A – Airway 189 B – Breathing 189 C – circulation 190 D – Neurological disability 190 E – Exposure with environment control 190 Classification of burn depth 190 Determination of burn depth 191 Laser Doppler scanning 191 Electrical burns 192 Chemical burns 193 Calculation of burn surface area 193 Management 193 Burn wound care 195 Preparation for theatre 197 Pain management via acute pain service 199 Post-operative care 200 Physiotherapy 200 Infection control 200 Toxic shock syndrome 201 Tetanus 202 Human immunodeficiency virus (HIV)-positive children 202 Scar management 202 Discharge planning 202 References 204 11 Paediatric transplantation – Rebecca Smith and Susan Tame 208 Introduction 208 Becoming an organ donor 208 Types of donation 209 Role of the transplant co-ordinator 213 Donor care and management 215 Making the donation request 215 Preoperative care of a potential paediatric donor 216 Perioperative care 222 Recipient management and care 229 Cardiothoracic organs 230 Immediate post-operative care 233 Liver 234 Kidneys 235 Small bowel, liver and multivisceral 237 Reducing the risk of rejection of the new organ 238 Longer-term post-operative care 239 The future 240 References 242 Further reading 243 12 The care of children having endoscopic procedures – Janet Roper and Linda Shields 245 Introduction 245 The perioperative nurse’s role 246 Preparing children for endoscopic procedures 248 Perioperative care 248 Service perspectives 249 Equipment for MIS and endoscopy 251 Conclusion 258 References 258 13 Ethical and legal issues in paediatric perioperative care – Linda Shields 261 Patients’ rights 261 Self-determination 262 Privacy 262 Confidentiality 262 Consent 263 Legal perspectives 264 Medical futility 265 Conclusion 265 References 266 Index 267

About the Author :
Linda Shields is Professor of Paediatric and Child Health Nursing at Curtin University, and the Child and Adolescent Health Service, Western Australia. Prior to that, she was Professor of Nursing at Hull University and Honorary Professor at the University of Queensland, Australia and Northumbria University, UK.

Review :
"This book offers not only an excellent introduction for the new pediatric nurse but also a good review for the experienced nurse." (AORN Journal, October 2010)