Solo peds case

[propadope]

I admit I’ve never tried the strap in a peds case, but love using it in adults. This sounds like the easiest solution to doin a peds case. Pop in an oral airway and strap them in.

As a side question, anyone know what that nose mask contraption the dentists use in kids is called.
View attachment 245110

Nasal hood. Its basically a Mapleson A circuit

 

[Noyac]

This stage 1 2 3 **** is nonsense. Just pin the arm down and put the IV in as soon as you’re sure the kid won’t remember.

I had a kid laryngospasm doing this a few months ago. Just saying.

 

[Velefunt]

I use a maskstrap +/- oral airway and hand off to the RN or sometimes an ENT, while I do the IV, if they don't have proficiency with peds IV's.

BTW, whenever you have a tourniquet, you've got a mask strap.

 

[Hork Bajir]

My favorite (Thanks @Noyac for the idea): place kid's hand over the mask sorta like he's holding it - this allows you to hold the mask down with your middle finger while while your index finger holds the wrist and your thumb holds the fingers down over the mask keeping the skin taut. Now pop in the IV while masking the whole time. Straight status.

I tried this today- worked OK (got the line in the hand no problem), but still had to ask the nurse for help since the elbow kept flopping out to the side, which would pull the hand away

 

[Consigliere]

You can also place an LMA (assuming inhalational induction) after breathing down, free yourself to place an IV then keep the LMA or remove and intubate if that is your airway plan. I saw a senior faculty member do this at Boston Children’s.

That's exactly what I do.

 

[Consigliere]

I admit I’ve never tried the strap in a peds case, but love using it in adults. This sounds like the easiest solution to doin a peds case. Pop in an oral airway and strap them in.

As a side question, anyone know what that nose mask contraption the dentists use in kids is called.
View attachment 245110

That's called the One-Less-Child-In-The-Family-Onater.

 

[T-burglar]

Extubate a 3 year old in a light plane of anesthesia...larygospasm is as predictable as the sun rising in the east.

Yeah but extubation or airway instrumentation aren't the same as IV placement

 

[HalO'Thane]

Yeah but extubation or airway instrumentation aren't the same as IV placement

It is still a painful stimuli that can precipitate laryngospasm under a light plane of anesthesia, especially in high-risk patients such as those under 2, patients with a URI, GERD, secondhand smoke, etc. He was merely responding to your comment that you didn’t think that laryngospasm was predictable or associated with stimulation, which is not true.