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Chapter 6 - Paediatric Anaesthesia in Non-specialist Centres

Published online by Cambridge University Press:  06 February 2025

James Ip
Affiliation:
Great Ormond Street Hospital for Children, London
Grant Stuart
Affiliation:
Great Ormond Street Hospital for Children, London
Isabeau Walker
Affiliation:
Great Ormond Street Hospital for Children, London
Ian James
Affiliation:
Great Ormond Street Hospital for Children, London
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Summary

The majority of paediatric surgery carried out is for minor procedures in fit and healthy children and can be performed as day-case procedures. A large quantity of this work is performed in non-specialist hospitals. Children and families need to be able to access high-quality services close to home, and delivering care locally, where possible to do so safely, can add to the patient and parent experience. A non-specialist centre should have arrangements and local guidance for treating and managing simple surgical emergencies in the paediatric population, along with the ability to resuscitate and stabilise critically ill children of all ages before transfer to a tertiary specialist centre for either paediatric critical care or surgery. Continual education and training within regional networks are vital in maintaining skills and confidence of staff in non-specialist centres, and standardisation along with protocols is helpful in the anaesthetic management, analgesic plan, preassessment and critical transfers of children in a non-specialist centre.

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Publisher: Cambridge University Press
Print publication year: 2025

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References

Further Reading

Campling, EA, Devlin, HB, Lunn, JN. The report of the National Confidential Enquiry into Perioperative Deaths 1989. 1989. Available at: www.ncepod.org.uk/1989report/Full%20Report%201989.pdf. Accessed 16 May 2021.Google Scholar
Engelhardt, T, Ayansina, D, Bell, GT et al. Incidence of severe critical events in paediatric anaesthesia in the United Kingdom: secondary analysis of the anaesthesia practice in children observational trial (APRICOT study). Anaesthesia 2019; 74:300–11.CrossRefGoogle ScholarPubMed
Getting it Right First Time. Reports. Available at: www.gettingitrightfirsttime.co.uk/girft-reports/. Accessed 14 March 2024.Google Scholar
NHS England and NHS Improvement. Paediatric critical care and surgery in children review. 2019. Available at: www.england.nhs.uk/wp-content/uploads/2019/11/paediatric-critical-care-and-surgery-in-children-review-summary-report-nov-2019.pdf. Accessed 14 March 2024.Google Scholar
Rollins, AM. Working together for the sick or injured child: the Tanner Report. Anaesthesia 2006; 61:1135–7.Google Scholar
Royal College of Anaesthetists. Chapter 10: guidelines for the provision of paediatric anaesthesia services. 2020. Available at: www.rcoa.ac.uk/gpas/chapter-10. Accessed 21 April 2024.Google Scholar
Royal College of Surgeons of England. Ensuring the provision of general paediatric surgery in the district general hospital. 2010. Available at: www.rcseng.ac.uk/library-and-publications/rcs-publications/docs/ensuring-the-provision-of-general-paediatric-surgery-in-the-district-general-hospital/. Accessed 21 April 2024.Google Scholar

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