The Pediatrician’s Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia

Abstract

Pediatricians play a key role in helping prepare patients and families for anesthesia and surgery. The questions to be answered by the pediatrician fall into 2 categories. The first involves preparation: is the patient in optimal medical condition for surgery, and are the patient and family emotionally and cognitively ready for surgery? The second category concerns logistics: what communication and organizational needs are necessary to enable safe passage through the perioperative process? This revised statement updates the recommendations for the pediatrician' s role in the preoperative preparation of patients. Pediatrics 2014;134:634-641 INTRODUCTIONPrimary care providers, including pediatricians, are frequently called on to evaluate and psychologically prepare patients and families before a child undergoes a procedure requiring anesthesia or sedation. This policy statement identifies that primary care provider' s preoperative goals of care are as follows: to clearly define the child' s medical issue; to delineate the physiologic effects and limitations imposed by each condition; and to optimize the management of any comorbid conditions. Furthermore, the policy recommends that pediatricians facilitate essential communication about the historical, physical, and laboratory findings in children with unusual or complex medical histories with the anesthesiologist and/or surgeon to ensure safe perioperative care.The objectives of the present statement were twofold:1. to describe to pediatricians the issues of concern to anesthesiologists and surgeons to improve the effectiveness of medical consultations in preparing pediatric patients and families for the perioperative period; and 2. to present information that will encourage and facilitate communication among surgeons, anesthesiologists, medical subspecialists, pediatricians, and other primary care providers.

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