The case A 37-month-old boy with snoring and large tonsils is scheduled for an adenotonsillectomy and bilateral ear tubes. He was born 5 weeks early. His growth is on the 5th percentile for weight and the 10th percentile for length. His family says that he snores loudly and sleeps restlessly. He is an active child and his mother wonders if he has attention-deficit hyperactivity disorder (ADHD). He has some language delay. He has not had a sleep study. He has had many ear infections. He has a mild runny nose. All his other organ systems are healthy. He has never had an anesthetic. Family history is noncontributory. There is no history suggestive of coagulopathy. On physical examination, he is 12 kg and thin. He is running around the room and comes over briefly to meet you but has to be held to listen to his chest. He has some crusted secretions around the nares and dark circles under his eyes. He breathes with his mouth open. He has kissing tonsils (they are touching in the midline). His chest sounds are clear and heart sounds normal. The abdomen is soft. Limbs appear normal. Patient care Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families. This will be the first anesthetic for this child.
|Original language||English (US)|
|Title of host publication||Core Clinical Competencies in Anesthesiology|
|Subtitle of host publication||A Case-Based Approach|
|Publisher||Cambridge University Press|
|Number of pages||6|
|State||Published - Jan 1 2010|
ASJC Scopus subject areas