1. BORDERS GENERAL HOSPITAL
April 2007

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

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

4. Distraction

5. Choice of Tourniquet

6. Cannulation

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

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

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

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

13. TPC first attempt cannulation

14. CONSULTANT / TRAINEE

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

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

19. ?

21. CHOICE OF TOURNIQUET

22. CHOICE OF TOURNIQUET

23. CHOICE OF TOURNIQUET

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

25. BORDERS GENERAL HOSPITAL
April 2007