u/Mrrgrotm

Recent grad with minimal pre experience. Practice does mostly elective healthy peds and some burns. For those that do peds frequently, during an emergent/urgent peds case, are you placing a preop IV or still masking. Had a 3y/o that wasn’t NPO with FB (kid stuck something up nose that was now far down in nasopharynx after another doc tried retrieving) that ENT deemed emergent due to risk of aspiration. Was a struggle placing preop IV because patient in addition to being 3, kid was developmentally delayed.

Would love to hear how others would approach the case.

One year out of residency and one my sites is an ASC eye center doing cataracts and plastic procedures. We get a fair amount of ASC 4’s and 3’s. Most non plastic are MAC so rarely cancel those cases, but then I’ll get little meemaw coming in with BP 200/100 talking about, “oh it’s just white coat syndrome. My BP is usually normal”. Those I tend to cancel, but proceed with 180’s.

For the plastic cases requiring general, if they’re an ASA 3 and if I have to look at any cardiac record, I feel it shouldn’t be done at an ASC. Colleagues say if patient is optimized and no current issue they proceed.