Introduction
In recent years, there have been an increasing number of paediatric procedures performed outside of the theatre environment by medical specialists and radiologists. This poses challenges when working in the less familiar environment for the theatre team, often with additional members of the multi-disciplinary team. In addition, staff procedure risks such as radiation exposure and infection control need to be considered. The overall aim is to provide the same high standard of care that patients receive in theatre areas.
This guide is written to support the multidisciplinary team in providing safe anaesthetic care for paediatric patients.
Locations
The locations that this guideline will cover include:
- Endoscopy suite
- Interventional Radiology (IR) suite
- MRI suite
Staffing
It is recommended that anaesthesia should be provided by a consultant or occasionally a senior trainee with consultant support, ideally on-site. It is important that all members of the anaesthetic team are familiar with working in these remote locations.
Endoscopy: There will be a consultant anaesthetist assigned to each daily elective list.
IR: cases are performed on a weekly theatre list in IR or ACAD theatres. Emergency or out of hours cases are covered by the on-call paediatric anaesthetic team.
MRI: There are elective paediatric MRI lists twice a week, but for non-elective MRIs, this is usually facilitated with the on-call anaesthetic team.
In addition to the paediatric ODPs, there are two additional ODPs in the IR suite covering adults patients, who if paediatrically trained could also be of assistance.
Out of Hours: All OOH cases should be discussed with the consultant paediatric anaesthetist
Equipment
Level of monitoring for anaesthesia should be the same as that provided in theatre. This should include:
- Continuous end-tidal CO2 capnography
- Non-invasive blood pressure monitoring
- Pulse oximeter
- Temperature monitoring for procedures lasting longer than an hour
- 3-lead ECG
- End-tidal Inspiratory and expiratory gases/vapours
Routine Equipment for anaesthesia should include:
- Equipment for airway management including video laryngoscopy
- Paediatric breathing systems
- Pulse oximetry
- Blood pressure cuffs
- Vascular access equipment including IO needles
- Devices to allow rapid fluid/drug delivery
- Equipment to warm fluids
- Patient warming devices
- Temperature measurement
- Paediatric TIVA pumps
- Trolley/bed capable of tipping into the head down position
Anaesthetic machines and other equipment must be checked before use in accordance with AAGBI guidelines. Anaesthetic machine checks should be recorded in a log by the anaesthetic practitioner and on the anaesthetic chart by the anaesthetist. It is important that all monitoring equipment is on the same service schedule as theatre equipment.
The monitoring at Royal London Hospital is the Philips Expression MR4000 and all members of the team should familiarise themselves with the equipment prior to any case.
MRI specific ECG electrodes are needed to monitor patients during anaesthesia.
The anaesthetic team must ensure an adequate supply of oxygen is available before starting any procedure. Back up cylinders should always be available in addition to piped gas supply.
Medication
A standard list of anaesthetic medication, including reversal agents, should be available and prepared for areas where anaesthesia or sedation is performed.
Anaesthetists should prepare their own medications when working in the endoscopy and MRI suite. Medication, including controlled drugs, is provided in all IR suites.
Emergency Equipment/Drugs
Please also refer to the Box app for guidelines related to the management of the associated emergencies.
Cardiac Arrest
In the event of a cardiac arrest, the scan/procedure should be stopped immediately. If arrest occurs in the MRI suite, members of the team should evacuate the patient as swiftly and safely as possible to the anaesthetic preparation area for resuscitation.
Trolley Locations
- Endoscopy: Main corridor in endoscopy
- IR: Outside IR
- MRI: In corridor outside MRI
Difficult Airway Trolley
- Endoscopy: Brought down from theatres by ODP
- IR: Brought down from theatres by ODP. Adult trolley in corridor behind IR theatres
- MRI: Brought down from theatres by ODP
Anaesthetic Emergency Drugs
- Endoscopy: Obtained from paediatric or ACAD theatres
- IR and MRI: Dantrolene and Intralipid is kept in clearly labelled boxes in the drug room at the back of IR rooms 1 and 2.
Massive Haemorrhage
- In the event of major haemorrhage, the team needs to call 2222 and state: Paediatric Major Haemorrhage Call at [Location] at Royal London Hospital
- Emergency blood is kept in the fridge in IR and 3th floor ACAD theatres fridge (for Endoscopy).
Pre-operative Assessment
For the majority of cases performed in the these remote areas, the pre-operative assessment for these patients will still initially performed on the paediatric day-case unit on 6B. Inpatients will be seen on the ward and emergency cases occasionally in ED.
Consent
It is the responsibility of the procedura list to consent the parent and/or patient for the specific procedure.
Patients with complex needs may need more thorough preoperative assessment and multidisciplinary discussion regard the best-interest decisions.
Learning disability team should be involved at earliest convenience for those patients. The LD CNS can be contacted on 07713099156
Some children with learning disabilities may have hospital passports that give caregivers some information to help provide more personalised care.
As per theatre cases, appropriate strategies for managing anxious children can be arranged for remote areas, e.g. play specialists
Pre-procedural Checks
When faced with an unfamiliar procedure, it is important that the team discuss important aspects of the procedure at the team brief that may include:
- Nature of the procedure
- Patient and equipment position
- Length of procedure
- Associated pain
- Possible side effects
- Equipment and devices to be used
With the advancement of interventional techniques, the potential for error increases and so surgical checklists have become standard. The WHO's 'Safe Surgery Saves Lives' checklist has been adapted for non-theatre environments. The purpose of these checks is to identify possible causes of error before they cause harm to the patient.
The NHS Commissioning Board Special Health Authority requires the WHO checklist to be completed for every patient undergoing a surgical procedure; this includes Sign In, Time Out and Sign Out.
All procedures should be compliant with National Safety Standards for Invasive Procedures (NatSSIPs) and the Safe Surgery Checklist.
MRI
Providing anaesthetic management in the MRI scanner is complex due to the limited patient access and remote environment. These challenges can be amplified in the context of a paediatric patient.
All patients and staff should be screened for implanted devices and the relevant safety of these devices prior to arrival into the MRI suite. It is the responsibility of the imaging department to ensure that patients are screened for these devices.
Devices can be largely divided into:
- MR Safe: No material would present a hazard at any field
- MR Conditional: Safe to scan under specified conditions detailed by the manufacturer
- MR Unsafe: Unacceptable risk to patients or staff in the MR environment.
If there is any doubt about a device/implant, please liaise with the MR Responsible Person.
Patients should have earplugs or ear defenders provided.
In the event of an emergency magnetic field shutdown or quench, it is important that all staff are aware of the departmental emergency quench procedure.
Recovery
- Endoscopy: Endoscopy recovery
- IR: MRI recovery room
- MRI: MRI recovery room
A plan for the recovery of patients with learning disabilities should be discussed in advance. It is of benefit if the patient can be recovered in a quieter room with earlier presence of a parent/guardian or learning disability nurse.
All patients should have met the following criteria before discharge from recovery:
- Vital signs within normal limits
- Patient appropriately awake
- Nausea, vomiting and pain appropriately managed
Escalation Policy
During the team brief, the team should discuss how and who to escalate to in the event of an emergency. All members of the team should familiarise themselves with the location of their nearest emergency buzzer.
In the first instance, the on-call paediatric anaesthetic team can be contacted via Dect phone 45661 or bleep 1061.
In the event of a cardiac arrest/medical emergency, it is appropriate for the team to call 2222 and put out a 'Paediatric Cardiac Arrest' or 'Neonatal Cardiac Arrest' call, dependent on the child's age.
In case of a surgical emergency, the team should contact the on-call paediatric surgical registrar on 45668.
If the patient needs to be transferred urgently to theatre, the team should also contact the paediatric theatre coordinator on 45663
If the patient requires critical care admission following the procedure, the PICU registrar can be contacted on 45667 or NICU registrar on 45853.