Welcome to another episode of The CARES VetMed Podcast! This week, Maryann, Travis, and our host tackle the unique challenges of pediatric anesthesia monitoring. From neonates to young adults, these little patients present distinct physiological differences that require tailored approaches. Join us as we explore essential tips, tricks, and common pitfalls to ensure the safest possible anesthetic experience for our smallest patients.

This episode covers:

  • Monitoring Equipment Adaptations: Practical advice for pulse oximetry in tiny patients, including using reflectance probes (rectal or shaved skin), relieving clamp pressure with needle caps or rubber bands, and the truth about "wetting the tongue." Discussion also covers adjusting the settings of an oscillometric blood pressure machine for small patients and the difficulties in obtaining accurate readings.

  • Pediatric Physiological Parameters: Insights into managing temperature in rapidly cooling/warming pediatric patients, and the surprising lack of direct correlation between hypotension and acute kidney injury in human pediatrics. We discuss how very young patients rely heavily on heart rate to estimate blood pressure, and how to prioritize physical assessments such as mucous membrane color, CRT, and fluid status.

  • Pharmacology & Protocols (Mini-Deep Dive): Brief discussion on using anticholinergics and ketamine in pediatric patients, especially for painful procedures, and the caution needed with propofol's cardiovascular effects. 

  • Lung Compliance and Ventilation: The critical importance of monitoring peak inspiratory pressure in pediatric patients due to their compliant chest walls but less compliant pulmonary tissue, and the risk of pulmonary edema from over-inflation.

  • Hypotension Intervention Strategies: A candid conversation about how to approach hypotension in pediatric patients, including when to intervene with multiple treatments simultaneously versus a stepwise approach, and the common use of pressors like dopamine.

  • Glucose Monitoring: Guidelines for checking blood glucose in pediatric patients, particularly those under six months, and techniques for obtaining blood samples.

We welcome your feedback, suggestions for future topics, or any wild experiences you'd like to share from your careers. Please reach out to us at hello@caresvetmed.com or connect with us on social media at @caresvetmed.


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