This is the first published report of the incidence of unexpected DBMV among healthy pediatric patients.

We report a case of a subserosal small bowel hematoma following an ilioinguinal-iliohypogastric nerve block for an appendicectomy in a 6-year-old girl. The bowel hematoma was noted in the wall of the terminal ileum after opening the peritoneum. The hematoma was nonobstructing and the child remained asymptomatic. We discuss the technical aspects of this block.

The use of prepared endotracheal tubes (PETTs) for unanticipated difficult intubation is common. However, the storage time of PETTs is highly variable and institution dependent since there is no standardized protocol. We sought to determine firstly if open, unused PETTs are a potential source of pathogenic microorganisms and secondly if PETTs can provide a medium for bacterial survival after deliberate contamination. M ME ET TH HO OD DS S An intubating stylet was inserted into a 7mm ETT and this system was ethylene oxide sterilized. The PETTs were placed in twenty different locations, including 14 operating rooms, 4 labour and delivery suites and 2 epidural carts. In phase one, the PETTs (n=20) were sampled at time zero, 24, 48 and 72 hours, and 1, 2, 3, and 4 weeks. The presence or absence of growth was determined after 48 hours incubation and the microorganism identified. For phase two, the distal end of the PETT (n=40) was swabbed with a fresh suspension of H. influenzae, P. aeruginosa, S. aureus, E. faecium or a negative control. The sampling and culturing of the PETTs was repeated as described in phase one. R RE ES SU UL LT TS S Non-virulent bacteria were cultured from 13 of 160 (8.1%) samples and from 15 of 320 (4.7%) samples in phases one and two respectively. No PETT grew the same bacteria more than once. In phase two, E. faecium was consistently recovered from the PETTs throughout the one month period. After 24 hours, the other three microorganisms were not recovered. D DI IS SC CU US SS SI IO ON N Our findings suggest that the pathogenic potential of open, unused PETTs is very low. The practice of storing PETTs as backup airway equipment for a period up to four weeks carries minimal risk of bacterial contamination. Based on this study PETTs can be safely used for up to one month. This practice could translate to significant cost reduction for operating room budgets.