BORDERS GENERAL HOSPITAL April 2007

Is it time to hang up the teddies? SPAN APRIL 2007

PAED DAY STAY ANAESTHESIA PREFERRED PROCESS: Personal nurse throughout Ametop cream Distraction and co-operation IV induction

Distraction

Choice of Tourniquet

Cannulation

What determines choice of tourniquet? Original Question… What determines choice of tourniquet?

AUDIT… Measured variable: First attempt success rate Population: Paediatric day cases Practitioner: Consultant anaesthetist +/- trainees

FIRST-ATTEMPT CANNULATION REASONABLE TARGET for FIRST-ATTEMPT CANNULATION in DAY CASE PAED GA? ?

Variables: Demographics Attempts at venepuncture Who was doing it Excuse for failures Choice of Tourniquet

TPC first attempt cannulation

CONSULTANT / TRAINEE

EXCUSES….. a selection “V DIFF VEINS” “Post Prem VEINS” “MORBID OBESITY (42 kg AGE 6)” “CHUBBY” “CHILD of CONST PAEDIATRICIAN”

Cannulation Audit - Questions Worthwhile Performance satisfactory Change practice / system Set higher/lower standard Make everybody do it! Hang up the teddies……

?

CHOICE OF TOURNIQUET

CHOICE OF TOURNIQUET

CHOICE OF TOURNIQUET

Tourniquet vs Age (mean = 7.7) 7.0 7.7 7.8 8.5 11 9.6

BORDERS GENERAL HOSPITAL April 2007