Jill E. Kilkelly; Stephen R. Hays
Vanderbilt University Medical Center
Nashville, TN, USA
Purpose/Relevance: There is increasing concern over possible adverse neurodevelopmental effects of anesthetic exposure in children. In particular, multiple anesthetic exposures are associated with increased risk of learning disability and other deficits. Our institution has developed a program to provide multiple procedures under a single anesthetic.
Target Audience: Practitioners performing or requesting procedures requiring anesthesia in children.
Current Practice: Multiple procedures requiring anesthesia in children are frequently scheduled without communication among requesting services, often resulting in fragmented care, logistical burden on patients and families, and multiple anesthetics.
Best Practice: The Complex Coordination of Care (CCOC) program developed by our division of pediatric anesthesia facilitates communication among requesting services, striving to consolidate multiple procedures requiring anesthesia into a single care encounter with a single anesthetic.
Expected Outcomes: Awareness of our CCOC program may promote similar approaches elsewhere, preventing fragmentation of care, easing logistical burden on patients and families, and reducing need for multiple anesthetics.
Format: PowerPoint presentation by two faculty, with subsequent discussion.
Summary: To our knowledge, our CCOC program is unique in working to consolidate multiple procedures requiring anesthesia into a single care encounter with a single anesthetic. In addition to promoting more efficient clinical care and reducing logistical burden on patient and families, such an approach may reduce risk of neurodevelopmental deficits associated with multiple anesthetic exposures in children.
References: Hays SR, Deshpande JK. Newly postulated neurodevelopmental risks of pediatric anesthesia: theories that could rock our world. J Urol 2013 Apr;189(4):1222-8.
Kilkelly JE, Kinch JS. An Innovative Paradigm: Coordinating Anesthetic Care for Complex Pediatric Patients requiring Multiple Procedures. J Anesth Clin Res 2015;5:490.
Sun LS, at al. incl. Hays SR. Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood. JAMA 2016 Jun 7;315(21):2312-20.
April 4 @ 12:15 PM
– 1:00 pm
Broadway Ballroom East E