PedsAnesthesiaNet - User contributions [en]

Assessment of Pain in Children

2026-10-11T12:55:47Z

WikiSysop:

{{Stub Notice}}

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14326 Functional near-infrared spectroscopy to assess pain in neonatal circumcisions]

[https://pubmed.ncbi.nlm.nih.gov/35271756/ Detection and assessment of postoperative pain in children with cognitive impairment: A systematic literature review and meta-analysis]

Manzar S
[https://www.jpedsurg.org/article/S0022-3468(23)00289-0/abstract Does the Newborn Infant Parasympathetic Evaluation Monitor Predict Post-Operative Pain?]
Journal of Pediatric Surgery, 2023; 581852

The Making of a Pediatric Anesthesiologist

2026-10-11T01:29:42Z

WikiSysop:

{{Stub Notice}}

See also: [[Diversity, Equity, and Inclusion]]

[https://pedsanesthesia.net/wiki/index.php/Main_Page#Care_of_the_Pediatric_Anesthesiologist Care of the Pediatric Anesthesiologist]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/02000/recognizing_the_awe_in_anesthesia.22.aspx Recognizing the Awe in Anesthesia]

[https://pmc.ncbi.nlm.nih.gov/articles/PMC11150991/pdf/i2333-0406-26-2-Hofkamp.pdf Identification, Characterization, and Ranking of Candidate Metrics for Selection to Anesthesiology Residency: An Iterative Survey of Program Directors]

Estright AW, Pruitt KA, Pope SE, Childers M, Clark SC, Singh M, et al. Educational Background and Demographic Characteristics of Anesthesiology Department Chairs in the United States. Anesthesiology Open. 2026;1(2):e0017.

Giam P. Redefining Leadership in Academic Anesthesiology: Balancing Operational Excellence and Scientific Mission. Anesthesiology Open. 2026;1(2):e0019. doi: 10.1097/ao9.0000000000000019.

Khanna, A. K., Pardo, M. C., Siddiqui, S., & Hopf, H. W. (2026). [https://www.ovid.com/jnls/monitor/fulltext/10.1097/01.asm.0001258396.80891.9b~making-a-dent-in-the-academic-universe Making a Dent in the Academic Universe. ASA Monitor], 90(9), 11–14.

Dual Training

[https://journals.lww.com/anesthesia-analgesia/Citation/2021/01000/The_Current_State_of_Combined_Pediatric.27.aspx The Current State of Combined Pediatric Anesthesiology–Critical Care Practice: A Survey of Dual-Trained Practitioners in the United States]

[https://www.jcvaonline.com/article/S1053-0770(23)00737-1/fulltext#%20 Anesthetic Management of an Infant with Dilated Cardiomyopathy and Congestive Heart Failure Undergoing Open Aortic Abdominal Aneurysm Repair: The Critical Role of Dual-Trained Pediatric and Adult Cardiothoracic Anesthesiologist]

[https://pubmed.ncbi.nlm.nih.gov/30649042/ The American Pediatric Critical Care Anesthesiologist: An Endangered Species Worth Saving]

Sub-Specialty Training

[https://pubmed.ncbi.nlm.nih.gov/35180170/ The Practice of Pediatric Cardiac Anesthesiology in the United States]

[https://pubmed.ncbi.nlm.nih.gov/38018084/ Pediatric cardiac anesthesiologists: an endangered species: a call to action]

Fellowship, Manpower, Training

[https://pubmed.ncbi.nlm.nih.gov/31743202/ Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?]

[https://pubmed.ncbi.nlm.nih.gov/34180976/ Association of Lifetime Earning Potential and Workforce Distribution Among Pediatric Subspecialists]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14564 Consumer research priorities for pediatric anesthesia and perioperative medicine]

[https://pubmed.ncbi.nlm.nih.gov/23095532/ United States anesthesiologists over 50: retirement decision making and workforce implications]

[https://pubmed.ncbi.nlm.nih.gov/33070377/ Coaching for the pediatric anesthesiologist: Becoming our best selves]

[https://link.springer.com/article/10.1007/s12630-024-02791-5 YouTube as a source of education in perioperative anesthesia for patients and trainees: a systematic review]

[https://pubmed.ncbi.nlm.nih.gov/34380931/ Accelerated 3-Year MD Pathway Programs: Graduates’ Perspectives on Education Quality, the Learning Environment, Residency Readiness, Debt, Burnout, and Career Plans]

[https://pubmed.ncbi.nlm.nih.gov/20107346/ Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010]

[https://pubmed.ncbi.nlm.nih.gov/22436952/ Shortening medical training by 30%]

[https://pubmed.ncbi.nlm.nih.gov/27805950/ Three-Year MD Programs: Perspectives From the Consortium of Accelerated Medical Pathway Programs (CAMPP)]

[https://pubmed.ncbi.nlm.nih.gov/2751777/ The McMaster M.D. program: a case study of renewal in medical education]

[https://pubmed.ncbi.nlm.nih.gov/27301381/ Accelerating medical education: a survey of deans and program directors]

[https://link.springer.com/article/10.1007/s12630-025-02909-3 The use of extended reality in anesthesiology education: a scoping review]

Compensation

[https://pubmed.ncbi.nlm.nih.gov/21262882/ Does Fellowship Pay: What Is the Long-term Financial Impact of Subspecialty Training in Pediatrics?]

[https://pubmed.ncbi.nlm.nih.gov/33685988/ Differences in Lifetime Earning Potential for Pediatric Subspecialists. Pediatrics]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/physician_unionization__opportunities_and.677.aspx Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States]

Mentorship

Farkas AH, Bonifacino E, Turner R, Tilstra SA, Corbelli JA. Mentorship of Women in Academic Medicine: a Systematic Review. J Gen Intern Med. Jul 2019;34(7):1322-1329. doi:10.1007/s11606-019-04955-2

Efstathiou JA, Drumm MR, Paly JP, et al. Long-term impact of a faculty mentoring program in academic medicine. PLoS One. 2018;13(11):e0207634. doi:10.1371/journal.pone.0207634

Nafiu OO, Haydar B. Mentoring Programs in Academic Anesthesiology: A Case for PROFOUND Mentoring for Underrepresented Minority Faculty. Anesth Analg. Jul 2019;129(1):316-320. doi:10.1213/ane.0000000000004202

[https://journals.lww.com/anesthesiology/fulltext/9900/training_the_next_generation_of_anesthesiologists_.888.aspx Training the Next Generation of Anesthesiologists: A Cross-sectional Mixed-methods Study on Mentorship in Anesthesiology]

The Making of a Pediatric Anesthesiologist

2026-10-11T01:28:52Z

WikiSysop:

{{Stub Notice}}

See also: [[Diversity, Equity, and Inclusion]]

[https://pedsanesthesia.net/wiki/index.php/Main_Page#Care_of_the_Pediatric_Anesthesiologist Care of the Pediatric Anesthesiologist]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/02000/recognizing_the_awe_in_anesthesia.22.aspx Recognizing the Awe in Anesthesia]

[https://pmc.ncbi.nlm.nih.gov/articles/PMC11150991/pdf/i2333-0406-26-2-Hofkamp.pdf Identification, Characterization, and Ranking of Candidate Metrics for Selection to Anesthesiology Residency: An Iterative Survey of Program Directors]

Estright AW, Pruitt KA, Pope SE, Childers M, Clark SC, Singh M, et al. Educational Background and Demographic Characteristics of Anesthesiology Department Chairs in the United States. Anesthesiology Open. 2026;1(2):e0017.

Giam P. Redefining Leadership in Academic Anesthesiology: Balancing Operational Excellence and Scientific Mission. Anesthesiology Open. 2026;1(2):e0019. doi: 10.1097/ao9.0000000000000019.

Khanna, A. K., Pardo, M. C., Siddiqui, S., & Hopf, H. W. (2026). [https://www.ovid.com/jnls/monitor/fulltext/10.1097/01.asm.0001258396.80891.9b~making-a-dent-in-the-academic-universe Making a Dent in the Academic Universe. ASA Monitor], 90(9), 11–14. https://doi.org/10.1097/01.ASM.0001258396.80891.9b

Dual Training

[https://journals.lww.com/anesthesia-analgesia/Citation/2021/01000/The_Current_State_of_Combined_Pediatric.27.aspx The Current State of Combined Pediatric Anesthesiology–Critical Care Practice: A Survey of Dual-Trained Practitioners in the United States]

[https://www.jcvaonline.com/article/S1053-0770(23)00737-1/fulltext#%20 Anesthetic Management of an Infant with Dilated Cardiomyopathy and Congestive Heart Failure Undergoing Open Aortic Abdominal Aneurysm Repair: The Critical Role of Dual-Trained Pediatric and Adult Cardiothoracic Anesthesiologist]

[https://pubmed.ncbi.nlm.nih.gov/30649042/ The American Pediatric Critical Care Anesthesiologist: An Endangered Species Worth Saving]

Sub-Specialty Training

[https://pubmed.ncbi.nlm.nih.gov/35180170/ The Practice of Pediatric Cardiac Anesthesiology in the United States]

[https://pubmed.ncbi.nlm.nih.gov/38018084/ Pediatric cardiac anesthesiologists: an endangered species: a call to action]

Fellowship, Manpower, Training

[https://pubmed.ncbi.nlm.nih.gov/31743202/ Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?]

[https://pubmed.ncbi.nlm.nih.gov/34180976/ Association of Lifetime Earning Potential and Workforce Distribution Among Pediatric Subspecialists]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14564 Consumer research priorities for pediatric anesthesia and perioperative medicine]

[https://pubmed.ncbi.nlm.nih.gov/23095532/ United States anesthesiologists over 50: retirement decision making and workforce implications]

[https://pubmed.ncbi.nlm.nih.gov/33070377/ Coaching for the pediatric anesthesiologist: Becoming our best selves]

[https://link.springer.com/article/10.1007/s12630-024-02791-5 YouTube as a source of education in perioperative anesthesia for patients and trainees: a systematic review]

[https://pubmed.ncbi.nlm.nih.gov/34380931/ Accelerated 3-Year MD Pathway Programs: Graduates’ Perspectives on Education Quality, the Learning Environment, Residency Readiness, Debt, Burnout, and Career Plans]

[https://pubmed.ncbi.nlm.nih.gov/20107346/ Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010]

[https://pubmed.ncbi.nlm.nih.gov/22436952/ Shortening medical training by 30%]

[https://pubmed.ncbi.nlm.nih.gov/27805950/ Three-Year MD Programs: Perspectives From the Consortium of Accelerated Medical Pathway Programs (CAMPP)]

[https://pubmed.ncbi.nlm.nih.gov/2751777/ The McMaster M.D. program: a case study of renewal in medical education]

[https://pubmed.ncbi.nlm.nih.gov/27301381/ Accelerating medical education: a survey of deans and program directors]

[https://link.springer.com/article/10.1007/s12630-025-02909-3 The use of extended reality in anesthesiology education: a scoping review]

Compensation

[https://pubmed.ncbi.nlm.nih.gov/21262882/ Does Fellowship Pay: What Is the Long-term Financial Impact of Subspecialty Training in Pediatrics?]

[https://pubmed.ncbi.nlm.nih.gov/33685988/ Differences in Lifetime Earning Potential for Pediatric Subspecialists. Pediatrics]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/physician_unionization__opportunities_and.677.aspx Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States]

Mentorship

Farkas AH, Bonifacino E, Turner R, Tilstra SA, Corbelli JA. Mentorship of Women in Academic Medicine: a Systematic Review. J Gen Intern Med. Jul 2019;34(7):1322-1329. doi:10.1007/s11606-019-04955-2

Efstathiou JA, Drumm MR, Paly JP, et al. Long-term impact of a faculty mentoring program in academic medicine. PLoS One. 2018;13(11):e0207634. doi:10.1371/journal.pone.0207634

Nafiu OO, Haydar B. Mentoring Programs in Academic Anesthesiology: A Case for PROFOUND Mentoring for Underrepresented Minority Faculty. Anesth Analg. Jul 2019;129(1):316-320. doi:10.1213/ane.0000000000004202

[https://journals.lww.com/anesthesiology/fulltext/9900/training_the_next_generation_of_anesthesiologists_.888.aspx Training the Next Generation of Anesthesiologists: A Cross-sectional Mixed-methods Study on Mentorship in Anesthesiology]

The Making of a Pediatric Anesthesiologist

2026-10-11T01:28:14Z

WikiSysop:

{{Stub Notice}}

See also: [[Diversity, Equity, and Inclusion]]

[https://pedsanesthesia.net/wiki/index.php/Main_Page#Care_of_the_Pediatric_Anesthesiologist Care of the Pediatric Anesthesiologist]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/02000/recognizing_the_awe_in_anesthesia.22.aspx Recognizing the Awe in Anesthesia]

[https://pmc.ncbi.nlm.nih.gov/articles/PMC11150991/pdf/i2333-0406-26-2-Hofkamp.pdf Identification, Characterization, and Ranking of Candidate Metrics for Selection to Anesthesiology Residency: An Iterative Survey of Program Directors]

Estright AW, Pruitt KA, Pope SE, Childers M, Clark SC, Singh M, et al. Educational Background and Demographic Characteristics of Anesthesiology Department Chairs in the United States. Anesthesiology Open. 2026;1(2):e0017.

Giam P. Redefining Leadership in Academic Anesthesiology: Balancing Operational Excellence and Scientific Mission. Anesthesiology Open. 2026;1(2):e0019. doi: 10.1097/ao9.0000000000000019.

Khanna, A. K., Pardo, M. C., Siddiqui, S., & Hopf, H. W. (2026). https://www.ovid.com/jnls/monitor/fulltext/10.1097/01.asm.0001258396.80891.9b~making-a-dent-in-the-academic-universe Making a Dent in the Academic Universe. ASA Monitor], 90(9), 11–14. https://doi.org/10.1097/01.ASM.0001258396.80891.9b

Dual Training

[https://journals.lww.com/anesthesia-analgesia/Citation/2021/01000/The_Current_State_of_Combined_Pediatric.27.aspx The Current State of Combined Pediatric Anesthesiology–Critical Care Practice: A Survey of Dual-Trained Practitioners in the United States]

[https://www.jcvaonline.com/article/S1053-0770(23)00737-1/fulltext#%20 Anesthetic Management of an Infant with Dilated Cardiomyopathy and Congestive Heart Failure Undergoing Open Aortic Abdominal Aneurysm Repair: The Critical Role of Dual-Trained Pediatric and Adult Cardiothoracic Anesthesiologist]

[https://pubmed.ncbi.nlm.nih.gov/30649042/ The American Pediatric Critical Care Anesthesiologist: An Endangered Species Worth Saving]

Sub-Specialty Training

[https://pubmed.ncbi.nlm.nih.gov/35180170/ The Practice of Pediatric Cardiac Anesthesiology in the United States]

[https://pubmed.ncbi.nlm.nih.gov/38018084/ Pediatric cardiac anesthesiologists: an endangered species: a call to action]

Fellowship, Manpower, Training

[https://pubmed.ncbi.nlm.nih.gov/31743202/ Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?]

[https://pubmed.ncbi.nlm.nih.gov/34180976/ Association of Lifetime Earning Potential and Workforce Distribution Among Pediatric Subspecialists]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14564 Consumer research priorities for pediatric anesthesia and perioperative medicine]

[https://pubmed.ncbi.nlm.nih.gov/23095532/ United States anesthesiologists over 50: retirement decision making and workforce implications]

[https://pubmed.ncbi.nlm.nih.gov/33070377/ Coaching for the pediatric anesthesiologist: Becoming our best selves]

[https://link.springer.com/article/10.1007/s12630-024-02791-5 YouTube as a source of education in perioperative anesthesia for patients and trainees: a systematic review]

[https://pubmed.ncbi.nlm.nih.gov/34380931/ Accelerated 3-Year MD Pathway Programs: Graduates’ Perspectives on Education Quality, the Learning Environment, Residency Readiness, Debt, Burnout, and Career Plans]

[https://pubmed.ncbi.nlm.nih.gov/20107346/ Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010]

[https://pubmed.ncbi.nlm.nih.gov/22436952/ Shortening medical training by 30%]

[https://pubmed.ncbi.nlm.nih.gov/27805950/ Three-Year MD Programs: Perspectives From the Consortium of Accelerated Medical Pathway Programs (CAMPP)]

[https://pubmed.ncbi.nlm.nih.gov/2751777/ The McMaster M.D. program: a case study of renewal in medical education]

[https://pubmed.ncbi.nlm.nih.gov/27301381/ Accelerating medical education: a survey of deans and program directors]

[https://link.springer.com/article/10.1007/s12630-025-02909-3 The use of extended reality in anesthesiology education: a scoping review]

Compensation

[https://pubmed.ncbi.nlm.nih.gov/21262882/ Does Fellowship Pay: What Is the Long-term Financial Impact of Subspecialty Training in Pediatrics?]

[https://pubmed.ncbi.nlm.nih.gov/33685988/ Differences in Lifetime Earning Potential for Pediatric Subspecialists. Pediatrics]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/physician_unionization__opportunities_and.677.aspx Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States]

Mentorship

Farkas AH, Bonifacino E, Turner R, Tilstra SA, Corbelli JA. Mentorship of Women in Academic Medicine: a Systematic Review. J Gen Intern Med. Jul 2019;34(7):1322-1329. doi:10.1007/s11606-019-04955-2

Efstathiou JA, Drumm MR, Paly JP, et al. Long-term impact of a faculty mentoring program in academic medicine. PLoS One. 2018;13(11):e0207634. doi:10.1371/journal.pone.0207634

Nafiu OO, Haydar B. Mentoring Programs in Academic Anesthesiology: A Case for PROFOUND Mentoring for Underrepresented Minority Faculty. Anesth Analg. Jul 2019;129(1):316-320. doi:10.1213/ane.0000000000004202

[https://journals.lww.com/anesthesiology/fulltext/9900/training_the_next_generation_of_anesthesiologists_.888.aspx Training the Next Generation of Anesthesiologists: A Cross-sectional Mixed-methods Study on Mentorship in Anesthesiology]

Hypotension

2026-10-09T11:23:20Z

WikiSysop:

{{Stub Notice}}

[https://link.springer.com/article/10.1007/s00134-024-07374-y Knowing the ropes of vasopressor dosing: a focus on norepinephrine]

[https://pubmed.ncbi.nlm.nih.gov/36906461/ Ephedrine to treat intraoperative hypotension in infants: what is the target?]

[https://pubmed.ncbi.nlm.nih.gov/35224636/ Recognition and Management of Cardiovascular Insufficiency in the Very Low Birth Weight Newborn]

[https://pubmed.ncbi.nlm.nih.gov/36639328/ Effective dose of ephedrine for treatment of hypotension after induction of general anaesthesia in neonates and infants less than 6 months of age: a multicentre randomised, controlled, open label, dose escalation trial]

[https://www.uptodate.com/contents/hemodynamic-management-during-anesthesia-in-adults?sectionName=Blood%20pressure%20targets&topicRef=112615&anchor=H1879584608&source=see_link%22%20%5Cl%20%22H1879584608%22 UpToDate: Hemodynamic management during anesthesia in adults]

[https://pubmed.ncbi.nlm.nih.gov/40324232/ Vasoactive-inotropic agents in pediatric patients undergoing cardiac surgery: A single-center retrospective study]

[https://pubmed.ncbi.nlm.nih.gov/39588800/ Inotropes for the prevention of low cardiac output syndrome and mortality for paediatric patients undergoing surgery for congenital heart disease: a network meta-analysis]

[https://pubmed.ncbi.nlm.nih.gov/16143539/ Vasoplegic syndrome--the role of methylene blue]

[https://pubmed.ncbi.nlm.nih.gov/20705641/ Vasopressin and methylene blue: alternate therapies in vasodilatory shock]

[https://www.ncbi.nlm.nih.gov/books/NBK507716/ Physiology, Catecholamines]

[https://link.springer.com/article/10.1186/s40560-025-00836-5 Management of endothelial dysfunction in septic shock: role of albumin administration]

de Martino N, Belghiti Alaoui M, Loreau C, Caruselli M, Michel F. [https://pubmed.ncbi.nlm.nih.gov/ 38270921 Use of norepinephrine for intraoperative hypotension in pediatric surgery.] Minerva Anestesiol. 2024 Apr;90(4):339-340. doi: 10.23736/S0375-9393.23.17800-X. Epub 2024 Jan 25. PMID: 38270921.

Measuring Outcome in Pediatric Anesthesia

2026-10-08T19:10:13Z

WikiSysop:

{{Stub Notice}}

[https://onlinelibrary.wiley.com/doi/10.1046/j.1460-9592.2001.00782.x Searching for the Holy Grail: measuring risk in paediatric anaesthesia]

[https://pubmed.ncbi.nlm.nih.gov/17263734/ Pediatric anesthesia - potential risks and their assessment: part I]

[https://pubmed.ncbi.nlm.nih.gov/17359398/ Pediatric anesthesia--potential risks and their assessment: part II]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2022/04000/an_evaluation_of_severe_anesthetic_related.14.aspx An Evaluation of Severe Anesthetic-Related Critical Incidents and Risks From the South African Paediatric Surgical Outcomes Study: A 14-Day Prospective, Observational Cohort Study of Pediatric Surgical Patients]

[http://hbiostat.org/bbr/ Biostatistics for Biomedical Research]

[https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01295-9/abstract Bayesian statistics for clinical research]

[https://pubmed.ncbi.nlm.nih.gov/35476807/ Setting a Universal Standard: Should We Benchmark Quality Outcomes for Pediatric Anesthesia Care?]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15755 How to perform and write a meta-analysis]

[https://pubmed.ncbi.nlm.nih.gov/36069894/ Perioperative Mortality in Pediatric Patients: A Systematic Review of Risk Assessment Tools for Use in the Preoperative Setting]

[https://www.apsf.org/article/the-anesthesia-incident-reporting-system-airs/ The Anesthesia Incident Reporting System (AIRS)]
[https://qualityportal.aqihq.org/AIRSMain/AIRSCaseEntry AIRS Case Entry]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/03000/introduction_to_bayesian_analyses_for_clinical.9.aspx Introduction to Bayesian Analyses for Clinical Research]

[https://pubmed.ncbi.nlm.nih.gov/36728715/ Outcomes in pediatric anesthesia: towards a universal language]

[https://pubmed.ncbi.nlm.nih.gov/31517675/ Beyond Anesthesia Toxicity: Anesthetic Considerations to Lessen the Risk of Neonatal Neurological Injury]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/05000/perioperative_anesthesia_related_complications_and.19.aspx Perioperative Anesthesia-Related Complications and Risk Factors in Children: A Cross-Sectional Observation Study in Rwanda]

[https://pubs.asahq.org/anesthesiology/article/139/4/A16/138848/Debunking-Developmental-Delay-Assessing Debunking Developmental Delay: Assessing Associations between Anesthesia in Infancy and Neurodevelopmental Outcomes]

[https://pubs.asahq.org/monitor/article/88/5/22/140071/Risk-Stratification-to-Predict-Perioperative Risk Stratification to Predict Perioperative Mortality in Children]

[https://link.springer.com/article/10.1007/s12630-024-02763-9 Development and implementation of local pediatric anesthesia performance metrics at a Canadian children’s hospital: a technical report]

[https://pubmed.ncbi.nlm.nih.gov/38851197/ Long-term outcomes of early exposure to repeated general anaesthesia in children with cystic fibrosis (CF-GAIN): a multicentre, open-label, randomised controlled phase 4 trial]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005232/141990/Short-term-outcomes-in-infants-following-general Short-term outcomes in infants following general anesthesia with low-dose sevoflurane/dexmedetomidine/remifentanil versus standard dose sevoflurane (The TREX trial)]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16420 The central limit theorem: The remarkable theory that explains all of of statistics]

[https://pubmed.ncbi.nlm.nih.gov/39107163/ Development and validation of a score for prediction of postoperative respiratory complications in infants and children (SPORC-C)]

[https://pubmed.ncbi.nlm.nih.gov/38423824/ Behavioural disorders after prenatal exposure to anaesthesia for maternal surgery]

[https://pubmed.ncbi.nlm.nih.gov/38423824/ Behavioural and neuropsychological outcomes in children exposed in utero to maternal labour epidural analgesia]

[https://www.bjaed.org/article/S2058-5349(24)00102-1/abstract Core concepts in statistics and research methods. Part I: statistical inference]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00682-2/abstract NAP7: high mortality risk in neonates and very low risk in children]

Tung A, Dutton RP. Anesthesia Quality Improvement: Current State and Future Opportunities. Anesthesiology 2025; 142(1):217-29. doi:10.1097/ALN.0000000000005252. PMID: 39655985.

Kanjia MK, Kurth CD, Hyman D, et al. Perspectives on Anesthesia and Perioperative Patient Safety: Past, Present, and Future. Anesthesiology. 2024;141(5):835-848. doi:10.1097/ALN.0000000000005164. PMID: 39377708.

Bhattacharya K. Takuo Aoyagi - a Tribute to the Brain Behind Pulse Oximetry. Indian J Surg. 2020 Dec;82(6):1332-1333. doi: 10.1007/s12262-020-02365-x. Epub 2020 May 20. PMID: 32837057; PMCID: PMC7237228.

Institute of Medicine Committee on Quality of Healthcare in America: Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C., National Academies Press, 2001.

Hollnagel E, Wears RL, Braithwaite J: From Safety-I to Safety-II: A White Paper. Denmark: Resilient Health Care Net. 2015. Available at: https://www.england.nhs.uk/signuptosafety/wp-content/uploads/ sites/16/2015/10/safety-1-safety-2-whte-papr.pdf.

Leveson N. Safety III: A Systems Approach to Safety and Resilience. MIT Engineering Systems Lab. Available at: https//sunnyday.mit.edu/safety-3.pdf.

Lawton R, Taylor N, Clay-Williams R, et al. Positive deviance: a different approach to achieving patient safety. BMJ Qual Saf 2014;23(11):880-3. doi:10.1136/bmjqs-2014-003115. PMID: 25049424.

[https://jamanetwork.com/journals/jama/fullarticle/2829289 Factorial Clinical Trial Designs]

[https://link.springer.com/article/10.1007/s12630-025-02943-1 Metrics to assess the quality of anesthesia, perioperative care, and acute pain management in Canada: a scoping review ]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.15133 Flipping the Conditional: Why We Are Probably Wrong About Probabilities]

Ioannidis J. Why Most Published Research Findings Are False. PLoS Medicine 2005; 2(8):696-701.DOI: 10.1371/journal.pmed.0020124

Sundström FTA, Lavefjord A, Buhrman M, McCracken LM. Are People With Chronic Pain More Diverse Than We Think? An Investigation of Ergodicity. Pain 2025; doi.org/10.1097/j.pain.0000000000003573

Vlaeyen JWS, Milde C. The Precarious Use of Group Data to Understand Individual Processes in Pain Science. Pain 2025; doi.org/10.1097/j.pain.0000000000003574

Leahy IC, Baier AW, Staffa SJ, Romano M, Brustowicz RM: Preterm and Early-Term Neonates: Independent Risk Factors Associated With Mortality After Surgery. Pediatrics Open Science 2025; 1: 1–7

[https://www.bjanaesthesia.org/article/S0007-0912(25)00299-5/fulltext Multidisciplinary, evidence-based, patient-centred perioperative patient safety recommendations: a European consensus study]

[https://jamanetwork.com/journals/jama/fullarticle/2839303 How to Communicate Medical Numbers]

VanderWeele TJ, Ding P. Sensitivity Analysis in Observational Research: Introducing the E-Value. Ann Intern Med. 2017;167(4):268-274. doi:10.7326/M16-2607

Systematic review
A systematic review summarizes the findings of primary research studies that address a specific research question. It uses explicit and reproducible methods to search, appraise, and synthesize the evidence.
Systematic reviews are often used to inform clinical guidelines and policy.

Meta-analysis
A meta-analysis is a statistical process that combines the results from multiple studies to estimate the overall effect of a variable or intervention. Meta-analyses are often an outcome of a systematic review.

Scoping review
A scoping review is a preliminary assessment of the available research literature on a topic. It aims to identify the nature and extent of the research evidence, including ongoing research. Scoping reviews are less rigorous than systematic reviews and are not usually used to inform policy and practice.

Quality Improvement Strategies

[https://pubmed.ncbi.nlm.nih.gov/34764497/ Adopting newer strategies of perioperative quality improvement: The bandwagon moves on…]

[https://pubmed.ncbi.nlm.nih.gov/36288819/ Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness]

[https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/mms/quality-measure-and-quality-improvement- CMS: Quality Measurement and Quality Improvement]

[https://journals.lww.com/ijebh/fulltext/2023/12000/implementation_science__a_primer.1.aspx Implementation science: a primer]

[https://pubmed.ncbi.nlm.nih.gov/29425593/ Implementation Science in Perioperative Care]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14439 Lean methodology in quality improvement]

Dakhale GN, Hiware SK, Shinde AT, Mahatme MS. Basic biostatistics for post-graduate students. Indian J Pharmacol. 2012 Jul-Aug; 44(4): 435-42. PMID: 23087501

Wissing DR, Timm D. Statistics for the nonstatistician: Part I. South Med J. 2012 Mar; 105(3): 126-30. PMID: 22392207

Hou W, Carden D. Statistics for the nonstatistician: Part II. South Med J. 2012 Mar; 105(3): 131-5. PMID: 22392208

[https://link.springer.com/content/pdf/10.1007/978-3-030-98175-4.pdf 📒 The Pathway to Publishing: A Guide to Quantitative Writing in the Health Science (Stephen Luby Dorothy L. Southern)]

Mascha EJ, Vetter TR. Significance, errors, power, and sample size: The blocking and tackling of statistics. Anesth Analg. 2018 Feb; 126(2): 691-698. PMID: 29346210

Pace NL. Experimental design and statistics. In: Barash PG, Cullen BF, Stoelting RK, et al., eds. Clinical Anesthesia. 8th ed. Philadelphia, PA: Wolters Kluwer; 2017: 170.

[https://www.bjaed.org/article/S2058-5349(25)00093-9/fulltext Core concepts in statistics and research methods. Part 5: systematic review and meta-analysis]

Murad MH, Montori VM, Ioannidis JP, Jaeschke R, Devereaux PJ, Prasad K, Neumann I, Carrasco-Labra A, Agoritsas T, Hatala R, Meade MO, Wyer P, Cook DJ, Guyatt G. How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA. 2014 Jul;312(2):171-9.

[https://www.researchgate.net/profile/Arumugam-Raman/post/could_anyone_can_help_me_to_better_understanding_of_the_statistical_values_in_simple_way_If_any_reference_pls_suggest_me/attachment/59d6280379197b80779865cf/AS%3A328274824712194%401455278225385/download/Book2.pdf Statistics for Non-Statisticians]

Illescas A, Zhong H, Cozowicz C, et al. Health services research in anesthesia: a brief overview of common methodologies. Anesth Analg. 2022 Mar; 134(3): 540-547. PMID: 35180171

Schober P, Vetter TR. Logistic regression in medical research. Anesth Analg. 2021 Feb; 132(2): 365-366. PMID: 33449558

[https://ekja.org/m/journal/view.php?doi=10.4097/kja.25973 Interpreting relative risks and odds ratios after propensity score matching: practical guidance for clinical research]

[https://journals.lww.com/anesthesia-analgesia/abstract/10.1213/ane.0000000000008064~tutorial-on-analyzing-paired-longitudinal-data-with-serial Tutorial on Analyzing Paired Longitudinal Data With Serial Correlation and Making Comparisons Between Groups, With Examples for Opioid Consumption and Quality of Life]

Needham M, Tonkins M [https://www.bjaed.org/article/S2058-5349(26)00055-7/abstract Collecting, analysing and presenting data for quality improvement projects: a practical guide] BJA Education, 2026; 26, 382-392

Andreae MH, Gabry JS, Goodrich B, White RS, Hall C. Antiemetic prophylaxis as a marker of health care disparities in the National Anesthesia Clinical Outcomes Registry. Anesth Analg. 2018 Feb; 126(2): 588-599. PMID: 29116968

Varughese AM, Buck DW, Lane-Fall MB, Heitmiller ES. Quality improvement in anesthesia practice and patient safety. In: Gropper MA, Cohen NH, Eriksson LI, Fleisher LA, Leslie K, Wiener-Kronish J, eds. Miller’s Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020: 96-100.

Achondroplasia

2026-10-08T19:08:02Z

WikiSysop:

{{Stub Notice}}
Dwarfism
Short stature

[https://pubmed.ncbi.nlm.nih.gov/34837063/ International Consensus Statement on the diagnosis, multidisciplinary management and lifelong care of individuals with achondroplasia]

[https://resources.wfsahq.org/atotw/anaesthesia-for-paediatric-patients-with-achondroplastic-short-stature/ Anaesthesia for Paediatric Patients with Achondroplastic short stature]

[https://pubmed.ncbi.nlm.nih.gov/22472460/ Atlanto-axial instability in achondroplastic dwarfs: a report of two cases and literature review]

[https://www.theguardian.com/film/2018/feb/01/three-billboards-portrayal-of-dwarfism-is-reductive-and-ableist-and-i-would-know Three Billboards' portrayal of dwarfism is reductive and ableist, and I would know]

[https://pubmed.ncbi.nlm.nih.gov/38485412/ New treatments for children with achondroplasia]

White KK, Bompadre V, Goldberg MJ, et al. Best practices in peri-operative management of patients with skeletal dysplasias. Am J Med Genet A 2017;173(10):2584-2595. (In eng). DOI: 10.1002/ajmg.a.38357.

4. Ornitz DM, Legeai-Mallet L. Achondroplasia: Development, pathogenesis, and therapy. Dev Dyn 2017;246(4):291-309. (In eng). DOI: 10.1002/dvdy.24479.

5. Hisado-Oliva A, Ruzafa-Martin A, Sentchordi L, et al. Mutations in C-natriuretic peptide (NPPC): a novel cause of autosomal dominant short stature. Genet Med 2018;20(1):91-97. (In eng). DOI: 10.1038/gim.2017.66.

6. Bocciardi R, Giorda R, Buttgereit J, et al. Overexpression of the C-type natriuretic peptide (CNP) is associated with overgrowth and bone anomalies in an individual with balanced t(2;7) translocation. Hum Mutat 2007;28(7):724-31. (In eng). DOI: 10.1002/humu.20511.

7. Savarirayan R, Tofts L, Irving M, et al. Safe and persistent growth-promoting effects of vosoritide in children with achondroplasia: 2-year results from an open-label, phase 3 extension study. Genet Med 2021;23(12):2443-2447. (In eng). DOI: 10.1038/s41436-021-01287-7.

[https://www.bjaed.org/article/S2058-5349(25)00041-1/abstract Anaesthesia for infants and young children with achondroplasia]

Theroux MC, Campbell JW. Anesthetic concerns of children with skeletal dysplasia. Neurosurg Clin N Am. 2022 Jan; 33(1): 37-47. PMID: 34801140

Pauli RM. Achondroplasia: a comprehensive clinical review. Orphanet J Rare Dis. 2019 Jan; 14(1): 1. PMID: 30606190

Assent/Consent

2026-10-08T19:06:24Z

WikiSysop:

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[https://biotech.law.lsu.edu/cases/consent/schoendorff.htm#:~:text=It%20is%20said%20that%20this,the%20malpractice%20of%20its%20physicians Basic right to consent to medical care - Schoendorff v. Society of New York Hosp]

[https://pediatrics.aappublications.org/content/131/4/786 The Legal Authority of Mature Minors to Consent to General Medical Treatment]

[https://pediatrics.aappublications.org/content/146/Supplement_1/S25 When Does A Minor’s Legal Competence To Make Health Care Decisions Matter?]

[https://www.bjaed.org/article/S2058-5349(20)30094-9/fulltext Consent and capacity: issues for paediatric anaesthesia]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993430/ A Modern History of Informed Consent and the Role of Key Information]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16176 Raising the bar: striving for excellence in consent]

[https://pubmed.ncbi.nlm.nih.gov/30113400/ Informed Consent in Pediatric Anesthesia: A Narrative Review]

[https://pubmed.ncbi.nlm.nih.gov/38242800/ Risk discussions in paediatric anaesthesia: a survey of current UK practice]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16692 The Paradox of Informed Consent]

[https://www.bjaed.org/article/S2058-5349(25)00095-2/abstract Perioperative care of patients who decline blood products]

[https://pubmed.ncbi.nlm.nih.gov/21288976/ Parental recall of anesthesia information: informing the practice of informed consent]

[https://pubmed.ncbi.nlm.nih.gov/29356830/ Informed Consent Training in Pediatrics - Are We Doing Enough?]

[https://pubmed.ncbi.nlm.nih.gov/31188793/ Consent Obtained by Residents: Informed by the Uninformed?]

Dutton RP. Risk Without Terror in Anesthesia Consent. Anesth Analg. 2026 May 1;142(5):866-868. doi: 10.1213/ANE.0000000000007865. Epub 2025 Nov 24. PMID: 41285000.

[https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Consent%20for%20Anaesthesia%20Guidelines%20from%20the%20Association%20of%20Anaesthetists.pdf Consent for anaesthesia: guidelines from the Association of Anaesthetists (2026)]

Lewis I, Burke C, Voepel-Lewis T, Tait AR. Children who refuse anesthesia or sedation: a survey of anesthesiologists. Paediatr Anaesth. 2007 Dec; 17(12): 1134-1142. PMID: 17986031

Informed consent, parental permission, and assent in pediatric practice. Committee on Bioethics, American Academy of Pediatrics. Pediatrics. 1995 Feb; 95(2): 314-317. PMID: 7838658

DiGeorge syndrome (22q11.2 deletion syndrome)

2026-10-08T19:03:01Z

WikiSysop:

Sickle Cell Disease

2026-10-08T18:59:15Z

WikiSysop:

This is a Stub Notice. This page has not been completed. You can work on this page by signing in and going to the Edit tab. Thanks for helping to make PedsAnesthesia.Net Wiki useful.

Go to the [[Main Page]] to see the Topic Outline.

Go to the [[Generalized Suggested Outline]] for information on case-specific details for each page.

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__NOTOC__ __NOEDITSECTION__

[https://pubmed.ncbi.nlm.nih.gov/37205803/ Current Evidence and Rationale to Guide Perioperative Management, Including Transfusion Decisions, in Patients With Sickle Cell Disease]

[[The anaesthetic management of children with sickle cell disease]]

[https://www.nejm.org/doi/full/10.1056/NEJM199507273330402 A Comparison of Conservative and Aggressive Transfusion Regimens in the Perioperative Management of Sickle Cell Disease]

[https://pubs.asahq.org/anesthesiology/article/101/3/766/9209/Sickle-Cell-Disease-and-Anesthesia Sickle Cell Disease and Anesthesia]

[https://www.bjaed.org/article/S2058-5349(18)30103-3/fulltext Anaesthetic management of children with sickle cell disease]

[https://pubmed.ncbi.nlm.nih.gov/36031024/ Special issue: Pediatric pain and sickle cell disease]

Brousse V, Elie C, Benkerrou M, et al. Acute splenic sequestration crisis in sickle cell disease: cohort study of 190 paediatric patients. Br J Haematol. 2012 Mar; 156(5): 643-8. PMID: 22224796

Al-Salem AH. Splenic complications of sickle cell anemia and the role of splenectomy. ISRN Hematol. 2011; 2011: 864257. PMID: 22084706

Kinney TR, Ware RE, Schultz WH, Filston HC. Long-term management of splenic sequestration in children with sickle cell disease. J Pediatr. 1990 Aug; 117(2 Pt 1): 194-9. PMID: 2380816

[https://www.apsf.org/article/preoperative-transfusion-and-sickle-cell-disease-in-the-pediatric-patient/ APSF: Preoperative Transfusion and Sickle Cell Disease in the Pediatric Patient]

Firth PG, McMillan KN, Haberkern CM, Yaster M, Bender MA, Goodwin SR. A survey of perioperative management of sickle cell disease in North America. PaediatrAnaesth 2011;21(1):43-49.

2. Goodwin SR, Haberkern C, Crawford M, Lerman J, Mancuso T, Yaster M. Sickle cell and anesthesia: do not abandon well-established practices without evidence. Anesthesiology 2005;103(1):205-207.

3. Vichinsky EP, Haberkern CM, Neumayr L, et al. A comparison of conservative and aggressive transfusion regimens in the perioperative management of sickle cell disease. The Preoperative Transfusion in Sickle Cell Disease Study Group [see comments]. NEnglJMed 1995;333(4):206-213.

4. Azbell RCG, Lanzkron SM, Desai PC. Current Evidence and Rationale to Guide Perioperative Management, Including Transfusion Decisions, in Patients With Sickle Cell Disease. Anesthesia and analgesia 2023;136(6):1107-1114. (In eng). DOI: 10.1213/ane.0000000000006463.

5. Baijal RG, Dalal PG, Kanjia M. Preoperative Transfusion and Sickle Cell Disease in the Pediatric Patient. Anesthesia Patient Safety Foundation. 06/2024 (https://www.apsf.org/article/preoperative-transfusion-and-sickle-cell-disease-in-the-pediatric-patient/?utm_source=APSF+Newsletter+Email+-+External&utm_medium=email&utm_campaign=EMAIL_CAMPAIGN_2024_06_01).

6. Hyder O, Yaster M, Bateman BT, Firth PG. Surgical procedures and outcomes among children with sickle cell disease. Anesthesia and analgesia 2013;117(5):1192-6. (In eng). DOI: 10.1213/ANE.0b013e3182a44d74.

7. Waldron P, Pegelow C, Neumayr L, et al. Tonsillectomy, adenoidectomy, and myringotomy in sickle cell disease: perioperative morbidity. Preoperative Transfusion in Sickle Cell Disease Study Group. JPediatrHematolOncol 1999;21(2):129-135.

8. Chou ST, Alsawas M, Fasano RM, et al. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Blood Adv 2020;4(2):327-355. (In eng). DOI: 10.1182/bloodadvances.2019001143.

9. Salvi PS, Solomon DG, Cowles RA. Preoperative Transfusion and Surgical Outcomes for Children with Sickle Cell Disease. J Am Coll Surg 2022;235(3):530-538. (In eng). DOI: 10.1097/xcs.0000000000000267.

10. Pignatti M, Zanella S, Borgna-Pignatti C. Can the surgical tourniquet be used in patients with sickle cell disease or trait? A review of the literature. Expert Rev Hematol 2017;10(2):175-182. (In eng). DOI: 10.1080/17474086.2017.1273765.

Howard J, Hart N, Roberts-Harewood M, et al. Guideline on the management of acute chest syndrome in sickle cell disease. Br J Haematol. 2015 May; 169(4): 492-505. PMID: 25824256

Delatte SJ, Hebra A, Tagge EP, Jackson S, Jacques K, Othersen HB Jr. Acute chest syndrome in the postoperative sickle cell patient. J Pediatr Surg. 1999 Jan; 34(1): 188-91; discussion 191-2. PMID: 10022169

Sohn E. Ease the Pain: The excruciating pain of sickle cell disease is difficult to prevent or treat. Researchers are working on new ways to provide relief. Sci Am 2024; 331(3): 94.

Reardon S. New Treatments for Sickle Cell Disease: After years of little progress, new therapies to treat or even cure the disease are reaching patients. Sci Am 2024; 331(3): 85.

Smith WR, Penberthy LT, Bovbjerg VE, et al. Daily assessment of pain in adults with sickle cell disease. Annals of internal medicine 2008; 148(2): 94-101.

Smith WR, Scherer M. Sickle-Cell Pain: Advances in Epidemiology and Etiology. Hematology 2010; 2010(1): 409-15.

Dampier C, Ely E, Brodecki D, O'Neal P. Home management of pain in sickle cell disease: a daily diary study in children and adolescents. J Pediatr Hematol Oncol 2002; 24(8): 643-7.

Brandow AM, Brousseau DC, Panepinto JA. Postdischarge pain, functional limitations and impact on caregivers of children with sickle cell disease treated for painful events. Br J Haematol 2009; 144(5): 782-8.

Ballas SK, Lusardi M. Hospital readmission for adult acute sickle cell painful episodes: frequency, etiology, and prognostic significance. Am J Hematol 2005; 79(1): 17-25.

Dampier CD, Telen MJ, Wun T, et al. A randomized clinical trial of the efficacy and safety of rivipansel for sickle cell vaso-occlusive crisis. Blood 2023; 141(2): 168-79.

Karimi M, Bahadoram M, Mafakher L, Rastegar M. Impact of Imatinib on reducing the painful crisis in patients with sickle cell disease. Hematol Transfus Cell Ther 2024; 46(4): 387-92.

"First Patient Begins Newly Approved Sickle Cell Gene Therapy." The New York Times, May 6, 2024.

[https://onlinelibrary.wiley.com/doi/10.1002/pbc.31458 Safety and Tolerability of Intravenous Lidocaine Infusions as Opioid Adjunct for Children Hospitalized With Sickle Cell Vaso-Occlusive Pain]

[https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01479-3 Guidelines for the management of emergencies and critical illness in pediatric and adult patients with sickle cell disease]

Tan Y, Kashyap Y, De La Toba E, Croslow SW, Gill M, Guo X, Ilktach G, Davy E, Molokie R, Wang ZJ et al: Hemorphins, atypical endogenous opiate peptides, in sickle cell disease and their association with pain. Pain 2026, 167(2):326–337.

Argueta DA, Gupta K: New kid on the block: hemorphins in sickle cell disease. Pain 2026, 167(2):249–250.

Mielczarek P, Hartman K, Drabik A, Hung HY, Huang EY, Gibula-Tarlowska E, Kotlinska JH, Silberring J: Hemorphins-From Discovery to Functions and Pharmacology. Molecules 2021, 26(13).

Lei J, Benson B, Tran H, Ofori-Acquah SF, Gupta K: Comparative Analysis of Pain Behaviours in Humanized Mouse Models of Sickle Cell Anemia. PloS one 2016, 11(8):e0160608.

[https://ashpublications.org/blood/article/139/26/3771/485065/Risk-of-vaso-occlusive-episode-after-exposure-to Risk of vaso-occlusive episode after exposure to corticosteroids in patients with sickle cell disease]

[https://ashpublications.org/blood/article/139/26/3678/485668/Pain-without-gain-steroids-and-sickle-crisis Pain without gain: steroids and sickle crisis]

[https://pubmed.ncbi.nlm.nih.gov/17079562/ Primary hemorrhagic stroke in children with sickle cell disease is associated with recent transfusion and use of corticosteroids]

Paschal RD. Perioperative management in sickle cell disease. South Med J. 2016 Sep; 109(9): 557-9. PMID: 27598361

Alotaibi GS, Alsaleh K, Bolster L, McMurtry MS, Wu C. Preoperative transfusion in patients with sickle cell disease to prevent perioperative complications: a systematic review and meta-analysis. Hematology. 2014 Dec; 19(8): 463-71. PMID: 24611757

Yawn BP, Buchanan GR, Afenyi-Annan AN, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA. 2014 Sep 10; 312(10): 1033-48. PMID: 25203083

Sandoval C, Stringel G, Ozkaynak MF, Tugal O, Jayabose S. Perioperative management in children with sickle cell disease undergoing laparoscopic surgery. JSLS. 2002 Jan-Mar; 6(1): 29-33. PMID: 12002293

Automated Internal Defibrillators

2026-10-08T18:57:44Z

WikiSysop:

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[https://pubmed.ncbi.nlm.nih.gov/21481077/ Pediatric pacemakers and ICDs: how to optimize perioperative care]

[https://pubs.asahq.org/anesthesiology/article/130/4/A15/20097/Stop-Interfering-Intraoperative-Management-of-ICDs Stop Interfering! Intraoperative Management of ICDs]

Wan EY, Rogers AJ, Lavelle M, et al. [https://pubmed.ncbi.nlm.nih.gov/38984417/ Periprocedural management and multidisciplinary care pathways for patients with cardiac implantable electronic devices: a scientific statement from the American Heart Association.] Circulation. 2024 Aug; 150(8): e183-e196. PMID: 38984417

[https://pubmed.ncbi.nlm.nih.gov/32032098 Practice advisory for the perioperative management of patients with cardiac implantable electronic devices: pacemakers and implantable cardioverter-defibrillators 2020: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Implantable Electronic Devices: erratum.] Anesthesiology. 2020 Apr; 132(4): 938. PMID: 32032098

The Former Premature Patient

2026-10-08T18:53:53Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/8295802/ Anesthesia and apnea. Perioperative considerations in the former preterm infant]

[https://pubmed.ncbi.nlm.nih.gov/2382858/ Life-threatening apnea following spinal anesthesia in former premature infants]

[https://pubmed.ncbi.nlm.nih.gov/14766693/ The distance from the skin to the subarachnoid space can be predicted in premature and former-premature infants]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/postanesthesia_apnea_in_former_preterm_and_term.27.aspx Postanesthesia Apnea in Former Preterm and Term Infants: A Qualitative Systematic Review and Meta-analysis]

The Former Premature Patient

2026-10-08T18:53:25Z

WikiSysop:

Anterior Mediastinal Mass

2026-10-08T18:08:26Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/31503096/ The Anesthetic Management of Anterior Mediastinal Masses in Children: A Review]

[https://pubmed.ncbi.nlm.nih.gov/25814524/ Pediatric Anterior Mediastinal Mass: A Review Article]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14210 Pediatric mediastinal mass algorithm: A quality improvement initiative to reduce time from presentation to biopsy]

[https://www.podbean.com/ew/pb-ag3jk-10a4697 Mediastinal mass algorithm, August 2021]

[https://pubmed.ncbi.nlm.nih.gov/34714957/ Anesthesia for Children with Anterior Mediastinal Masses]

[https://pubmed.ncbi.nlm.nih.gov/34724550/ Mediastinal Masses, Anesthetic Interventions, and Airway Compression in Adults: A Prospective Observational Study]

[https://onlinelibrary.wiley.com/doi/epdf/10.1111/pan.14281 Risk factors for anesthetic‐related complications in pediatric patients with a newly diagnosed mediastinal mass]

[https://pubmed.ncbi.nlm.nih.gov/34714957/ Anesthesia for children with anterior mediastinal masses]

[https://pubmed.ncbi.nlm.nih.gov/30089066/ Anesthesia in a Patient with a Large Mediastinal Mass]

[https://pubmed.ncbi.nlm.nih.gov/36453783/ Emergency application of extracorporeal membrane oxygenation in a pediatric case of sudden airway collapse due to anterior mediastinal mass: A case report and review of literature]

[https://pubmed.ncbi.nlm.nih.gov/35748036/ Predictive risk score of respiratory complications in children with mediastinal tumors: A case-control study]

[https://pubmed.ncbi.nlm.nih.gov/37261097/ The evolution of anesthesia management of patients with anterior mediastinal mass]

[https://www.ncbi.nlm.nih.gov/books/NBK546608/ StatPearls: Anterior Mediastinal Mass]

[https://pubs.asahq.org/anesthesiology/article/103/3/661/8663/Cardiovascular-Collapse-Induced-by-Position Cardiovascular Collapse Induced by Position-dependent Pulmonary Vein Occlusion in a Patient with Fibrosing Mediastinitis]

[https://www.openanesthesia.org/keywords/anterior-mediastinal-masses-in-children/ OpenAnesthesia: Anterior Mediastinal Masses in Children]

Chen C, Wang Y, Wu J
[https://www.jcvaonline.com/action/showCitFormats Perioperative Anesthetic Management of Giant Mediastinal Tumors: Current Advances and Evidence-Based Strategies]
Journal of Cardiothoracic and Vascular Anesthesia, 2026; 40, 3377-3385

Managing Knowledge

2026-10-08T17:30:38Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/37474421/ Large language models in anaesthesiology: use of ChatGPT for American Society of Anesthesiologists physical status classification]

[https://www.anesthesiologynews.com/Technology/Article/09-26/Pediatric-Anesthesia-Experts-Assess-Artificial-Intelligence/81485 Artificial Intelligence in Pediatric Anesthesia: 3 Experts Weigh In]

[https://pubmed.ncbi.nlm.nih.gov/37667258/ Prediction of American Society of Anesthesiologists Physical Status Classification from preoperative clinical text narratives using natural language processing]

[https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00021-3/fulltext ChatGPT: the future of discharge summaries?]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00598-1/fulltext Generation of preoperative anaesthetic plans by ChatGPT-4.0: a mixed-method study]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/02000/the_future_of_artificial_intelligence_using_images.14.aspx The Future of Artificial Intelligence Using Images and Clinical Assessment for Difficult Airway Management]

[https://openevidence.com OpenEvidence]

Bauer MS, Kirchner J. [https://pubmed.ncbi.nlm.nih.gov/31036287/ Implementation science: What is it and why should I care?] Psychiatry Res. Jan 2020;283:112376. doi:10.1016/j.psychres.2019.04.025

[https://www.bjanaesthesia.org/article/S0007-0912(25)00003-0/fulltext A clinical decision support tool for acute pain within an electronic health record to improve analgesic prescribing practice]

[https://journals.lww.com/anesthesiology/fulltext/2025/04000/strengthening_discovery_and_application_of.10.aspx Strengthening Discovery and Application of Artificial Intelligence in Anesthesiology: A Report from the Anesthesia Research Council]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/06000/an_exploratory_analysis_of_chatgpt_compared_to.3.aspx An Exploratory Analysis of ChatGPT Compared to Human Performance With the Anesthesiology Oral Board Examination: Initial Insights and Implications]

[https://journals.lww.com/anesthesiology/fulltext/2025/09000/leveraging_large_language_models_to_enhance.13.aspx Leveraging Large Language Models to Enhance Emotional Intelligence Training in Anesthesiology]

[https://rapm.bmj.com/content/early/2025/09/02/rapm-2025-106852 Recommendations for disclosure of artificial intelligence in scientific writing and publishing: a regional anesthesia and pain medicine modified Delphi study]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16733 Guidance for reporting artificial intelligence technology evaluations for ultrasound scanning in regional anaesthesia (GRAITE-USRA): an international multidisciplinary consensus reporting framework]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16755 Real-world deployment and evaluation of PEri-operative AI CHatbot (PEACH): a large language model chatbot for peri-operative medicine]

[https://journals.lww.com/aacr/fulltext/2025/10000/the_potential_impacts_of_artificial_intelligence.2.aspx The Potential Impacts of Artificial Intelligence on Preoperative Optimization and Predicting Risks of Morbidity and Mortality: A Narrative Focused Review]

[https://www.science.org/doi/10.1126/science.adw3000 Scientific production in the era of large language models]

[https://jamanetwork.com/journals/jama/fullarticle/2842278 New Guidance on Responsible Use of AI]

[https://www.newyorker.com/magazine/2026/02/02/did-a-celebrated-researcher-obscure-a-fatal-poisoning The New Yorker: Did a Celebrated Researcher Obscure a Baby’s Poisoning?]

[https://publichealth.jhu.edu/2025/how-to-understand-a-research-study How to Understand a Research Study]

[https://www.bjanaesthesia.org/article/S0007-0912(26)00177-7/abstract Machine learning models in anaesthesiology: bridging the gap from model training to implementation]

Blakeslee, Sarah (2004) [https://commons.emich.edu/loexquarterly/vol31/iss3/4 "The CRAAP Test,"] LOEX Quarterly: Vol. 31: No. 3, Article 4.
Available at: https://commons.emich.edu/loexquarterly/vol31/iss3/4

== Academic/Research Fraud ==

Marcus A, Oransky I: An epidemic of scientific fakery threatens to overwhelm publishers. In: An epidemic of scientific fakery threatens to overwhelm publishers. The Washington Post; 2024.

2. Taub B: A reporter at large: Did a Celebrated Researcher Obscure a Baby’s Poisoning? After a newborn died of opioid poisoning, a new branch of pediatrics came into being. But the evidence doesn’t add up. In: The New Yorker Magazine. 2026: 28–39.

3. Ciszkowski C, Madadi P, Phillips MS, Lauwers AE, Koren G: Codeine, ultrarapid-metabolism genotype, and postoperative death. The New England journal of medicine 2009, 361(8):827–828.

4. Lam J, Woodall KL, Solbeck P, Ross CJ, Carleton BC, Hayden MR, Koren G, Madadi P: Codeine-related deaths: The role of pharmacogenetics and drug interactions. Forensic science international 2014, 239:50–56.

5. Madadi P, Avard D, Koren G: Pharmacogenetics of opioids for the treatment of acute maternal pain during pregnancy and lactation. Curr Drug Metab 2012, 13(6):721–727.

6. Smith R: Investigating the previous studies of a fraudulent author. BMJ (Clinical research ed) 2005, 331(7511):288–291.

7. Polaner DM, Shafer SL: Falling Dominoes. Anesthesia and analgesia 2019, 128(4):613–614.

[https://www.nature.com/articles/d41586-026-01100-y Scientists invented a fake disease. AI told people it was real]

[https://pmc.ncbi.nlm.nih.gov/articles/PMC12228860/pdf/40670_2025_Article_2379.pdf The Paradox of Knowledge: Why Medical Students Know More But Understand Less]

[https://jamanetwork.com/journals/jama/fullarticle/2852772 Updated Guidance for Author Use of AI in Medical Publication]

Augoustides J
[https://www.jcvaonline.com/article/S1053-0770(26)00456-8/fulltext Artificial Intelligence in Academic Publishing: Important Dynamic Considerations For Authors, Reviewers, Editors, and Publishers] Journal of Cardiothoracic and Vascular Anesthesia, 2026; 40, 2643-2645

Tumor Lysis Syndrome

2026-10-08T11:41:16Z

WikiSysop:

Tumor Lysis Syndrome

2026-10-08T11:40:11Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/11240885/ Tumour lysis syndrome during anaesthesia]

[https://pubmed.ncbi.nlm.nih.gov/18477278/ Fatal peri-operative tumour lysis syndrome precipitated by dexamethasone]

[https://pubmed.ncbi.nlm.nih.gov/18230072/ Tumor lysis syndrome with dexamethasone use in a child with leukemia]

[https://pubmed.ncbi.nlm.nih.gov/19032562/ Tumor lysis under anesthesia in a child]

Bociek RG, Lunning M: Tumor Lysis Syndrome. The New England journal of medicine 2025, 393(11):1104–1116.

Goldman SC, Holcenberg JS, Finklestein JZ, Hutchinson R, Kreissman S, Johnson FL, Tou C, Harvey E, Morris E, Cairo MS: A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood 2001, 97(10):2998–3003.

Flood K, Rozmus J, Skippen P, Matsell DG, Mammen C: Fluid overload and acute kidney injury in children with tumor lysis syndrome. Pediatric blood & cancer 2021, 68(12):e29255.

Al Blewi SM, AlAzmi AA, Elimam N, Jastaniah W, Mohammedkhalil A, Abdullah S: A Retrospective Single-Center Study of Sevelamer Hydrochloride for the Treatment of Hyperphosphatemia in Children With Tumor Lysis Syndrome. Cureus 2023, 15(1):e33533.

Goldman SC, Holcenberg JS, Finklestein JZ, Hutchinson R, Kreissman S, Johnson FL, Tou C, Harvey E, Morris E, Cairo MS: A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood 2001, 97(10):2998–3003.

Flood K, Rozmus J, Skippen P, Matsell DG, Mammen C: Fluid overload and acute kidney injury in children with tumor lysis syndrome. Pediatric blood & cancer 2021, 68(12):e29255.

Al Blewi SM, AlAzmi AA, Elimam N, Jastaniah W, Mohammedkhalil A, Abdullah S: A Retrospective Single-Center Study of Sevelamer Hydrochloride for the Treatment of Hyperphosphatemia in Children With Tumor Lysis Syndrome. Cureus 2023, 15(1):e33533.

Ventilation

2026-10-07T04:31:11Z

WikiSysop:

{{Stub Notice}}

See also:

:[[Breathing Circuits]]
:[[Intraoperative Atelectasis]]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14378 Understanding pediatric ventilation in the operative setting. Part I: Physical principles of monitoring in the modern anesthesia workstation]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14366 Understanding pediatric ventilation in the operative setting. Part II: Setting perioperative ventilation]

[https://www.ovid.com/jnls/anesthesiology/fulltext/10.1097/aln.0000000000006149~anesthesia-workstation-performance-in-pediatric-ventilation Anesthesia Workstation Performance in Pediatric Ventilation: Part 1. Precision of Ventilation]

[https://www.ovid.com/jnls/anesthesiology/fulltext/10.1097/aln.0000000000006150~anesthesia-workstation-performance-in-pediatric-ventilation Anesthesia Workstation Performance in Pediatric Ventilation: Part 2. Characteristics during Pressure Support Ventilation and Oxygen Rise Times]

[https://www.resmedjournal.com/article/S0954-6111(18)30020-9/fulltext Airway clearance techniques in neuromuscular disorders: A state of the art review]

[[TYK19|Test Your Knowledge]]:ventilation, mean airway pressure, pressure control

[https://pubmed.ncbi.nlm.nih.gov/35803726/ Pleural and transpulmonary pressures to tailor protective ventilation in children]

[https://pubmed.ncbi.nlm.nih.gov/36100276/ 2021 Year in Review - Pediatric Mechanical Ventilation]

[https://pubmed.ncbi.nlm.nih.gov/12580216/ Atelectasis formation during anesthesia: causes and measures to prevent it]

[https://pubmed.ncbi.nlm.nih.gov/34499087/ Perioperative Pulmonary Atelectasis: Part I. Biology and Mechanisms]

[https://pubmed.ncbi.nlm.nih.gov/34710217/ Perioperative Pulmonary Atelectasis: Part II. Clinical Implications]

[https://pubmed.ncbi.nlm.nih.gov/30260897/ Individual Positive End-expiratory Pressure Settings Optimize Intraoperative Mechanical Ventilation and Reduce Postoperative Atelectasis]

[https://pubmed.ncbi.nlm.nih.gov/20608554/ Mechanisms of atelectasis in the perioperative period]

[https://pubmed.ncbi.nlm.nih.gov/35791748/ Randomized controlled trial of low vs high oxygen during neonatal anesthesia: Oxygenation, feasibility, and oxidative stress]

[https://journals.lww.com/ejanaesthesiology/Abstract/2023/07000/Alveolar_target_ventilation_and_dead_space_in.7.aspx Alveolar target ventilation and dead space in children under anaesthesia - The proventiped cohort study]

[https://pubmed.ncbi.nlm.nih.gov/16548815/ Cuirass ventilation: a review and update]

[https://pubmed.ncbi.nlm.nih.gov/37587006/ Modern cuirass ventilation for airway surgery: unlimited access to the larynx and trachea in anaesthetised patients]

[https://pubmed.ncbi.nlm.nih.gov/28974067/ High intraoperative inspiratory oxygen fraction and risk of major respiratory complications]

[https://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2010.02334.x Oxygen concentration and characteristics of progressive atelectasis formation during anaesthesia]

[https://www.openanesthesia.org/keywords/anesthesia-breathing-systems/ OpenAnesthesia: Anesthesia Breathing Systems]

[https://pubmed.ncbi.nlm.nih.gov/38215710/ Mechanical Ventilation, Past, Present, and Future]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14808 Noninvasive respiratory support preventing reintubation after pediatric cardiac surgery—A systematic review]

[https://pubs.asahq.org/anesthesiology/article/136/2/326/118008/Too-Much-of-a-Good-Thing-Iatrogenic-Pediatric Too Much of a Good Thing: Iatrogenic Pediatric Pneumothorax from Engagement of the Oxygen Flush Valve]

[https://pubmed.ncbi.nlm.nih.gov/38561049/ Predicting Extubation Readiness in Preterm Infants Utilizing Machine Learning: A Diagnostic Utility Study]

[https://journals.lww.com/ejanaesthesiology/fulltext/2024/06000/effects_of_closed_loop_ventilation_on_ventilator.6.aspx Effects of closed loop ventilation on ventilator settings, patient outcomes and ICU staff workloads – a systematic review]

[https://pubmed.ncbi.nlm.nih.gov/39021139/ Clinical validation of the Air-Test for the non-invasive detection of perioperative atelectasis in children]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00470-7/abstract Association between inspired oxygen fraction and development of postoperative pulmonary complications in thoracic surgery: a multicentre retrospective cohort study]

Loi B, Sartorius V, Vivalda L, et al. Global and Regional Heterogeneity of Lung Aeration in Neonates with Different Respiratory Disorders: A Physiologic Observational Study. Anesthesiology 2024;141(4):719-731. (In eng). DOI: 10.1097/aln.0000000000005026.

Sett A, Dahm SI, Tingay DG. Lung Ultrasound and Regional Heterogeneity: A Bedside Solution to an Underrecognized Problem? Anesthesiology 2024;141(4):635-637. (In eng). DOI: 10.1097/aln.0000000000005136.

Angurana SK, Sudeep KC, Prasad S. Ventilator-induced lung injury in children. Journal of Pediatric Critical Care 2023;10(3):107-114. DOI: 10.4103/jpcc.jpcc_27_23.

Neumann RP, von Ungern-Sternberg BS. The neonatal lung – physiology and ventilation. Pediatric Anesthesia 2014;24(1):10-21. DOI: https://doi.org/10.1111/pan.12280.

RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The New England journal of medicine 2000;342(18):1301-8. (In eng). DOI: 10.1056/nejm200005043421801

Feldman JM. Optimal ventilation of the anesthetized pediatric patient. Anesth Analg. 2015 Jan; 120(1): 165-75. PMID: 25625261

Neumann RP, von Ungern-Sternberg BS. The neonatal lung--physiology and ventilation. Paediatr Anaesth. 2014 Jan; 24(1): 10-21. PMID: 24152199

[https://pubmed.ncbi.nlm.nih.gov/34614266/ The effect of oxygen concentration on atelectasis formation during induction of general anesthesia in children: A prospective randomized controlled trial] [https://onlinelibrary.wiley.com/doi/full/10.1111/pan.14286?saml_referrer Editorial]

Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: a narrative review. Can J Respir Ther. 2019 May 2; 55: 40-46. PMID: 31297448

Bouchut JC, Godard J, Claris O. High-frequency oscillatory ventilation. Anesthesiology. 2004 Apr; 100(4): 1007-12. PMID: 15087640

[https://www.bjanaesthesia.org/article/S0007-0912(25)00145-X/fulltext Weaning failure from mechanical ventilation: a scoping review of the utility of ultrasonography in the weaning process]

Kaiser HA, Bauer T, Riva T, et al. Carbon dioxide and cardiac output as major contributors to cerebral oxygenation during apnoeic oxygenation. Sci Rep 2024;14(1):3617. (In eng). DOI: 10.1038/s41598-023-49238-3.

Riva T, Greif R, Kaiser H, et al. Carbon Dioxide Changes during High-flow Nasal Oxygenation in Apneic Patients: A Single-center Randomized Controlled Noninferiority Trial. Anesthesiology 2022;136(1):82-92. (In eng). DOI: 10.1097/aln.0000000000004025.

Schwartz AE, Sandhu AA, Kaplon RJ, et al. Cerebral blood flow is determined by arterial pressure and not cardiopulmonary bypass flow rate. Ann Thorac Surg 1995;60(1):165-9; discussion 169-70. (In eng).

[https://sofia.medicalistes.fr/spip/IMG/pdf/aisys_cs2_user_s_reference_manual.pdf Aisys CS² User's Reference Manual]

[https://journals.lww.com/anesthesiology/fulltext/2025/11000/evaluation_of_the_potential_for_lung_recruitment.18.aspx Evaluation of the Potential for Lung Recruitment with the Recruitment-to-Inflation Ratio during General Anesthesia]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00639-7/fulltext Positive end-expiratory pressure optimisation during general anaesthesia in patients with obesity: a narrative review of respiratory and cardiovascular outcomes]

[https://pubmed.ncbi.nlm.nih.gov/40626802/ Automated Volatile Anesthetics Delivery with End-tidal Control: Early Results from Adoption at Missouri University Hospital]
:[https://journals.lww.com/anesthesiology/fulltext/9900/automated_volatile_anesthetic_delivery_with.863.aspx Comment]
:[https://journals.lww.com/anesthesiology/fulltext/9900/automated_volatile_anesthetics_delivery_with.865.aspx Reply]

[https://journals.lww.com/anesthesiology/fulltext/2026/05000/from_energy_to_injury__mechanical_power_and_lung.5.aspx From Energy to Injury: Mechanical Power and Lung Strain]

De La Rubia S, Loi B, Vivalda L, Dellacà R, Piastra M, Conti G, Antonelli M, Grieco DL, Di Nardo M, De Luca D. [https://pubmed.ncbi.nlm.nih.gov/42101008 Mechanical Power and Energy in Invasively Ventilated Newborn Infants.] Anesthesiology. 2026 Sep 1;145(3):664-675. doi: 10.1097/ALN.0000000000006128. Epub 2026 May 8. PMID: 42101008; PMCID: PMC13460320

Cressoni M, Gotti M, Chiurazzi C, Massari D, Algieri I, Amini M, Cammaroto A, Brioni M, Montaruli C, Nikolla K, Guanziroli M, Dondossola D, Gatti S, Valerio V, Vergani GL, Pugni P, Cadringher P, Gagliano N, Gattinoni L. [https://pubmed.ncbi.nlm.nih.gov/26872367 Mechanical Power and Development of Ventilator-induced Lung Injury.] Anesthesiology. 2016 May;124(5):1100-8. doi: 10.1097/ALN.0000000000001056. PMID: 26872367.

Pocket Reference Cards

2026-10-06T14:30:46Z

WikiSysop:

Here are links to known Pocket Reference Cards for Pediatric Anesthesia. Be sure to check info/calculations before use.

[https://pedsanesthesia.net/wiki/images/4/4b/ACCM_Pocket_Reference_2023.pdf Hopkins Peds Pocket Reference Card 2023] - [https://pedsanesthesia.net/wiki/images/f/fc/Hopkins_Pedi_Anes_Pocket_Card.pdf PDF]

[https://indd.adobe.com/view/3d369c34-c1f1-4190-9ce4-12000a3c6709 Stanford Pediatric Anesthesia Reference Card]

[https://indd.adobe.com/view/561a8de0-a844-4dc1-8703-803ea2590a36 Children's Hospital Colorado 2024 Peds Card]

[https://onepagericu.com/hyperthermic_toxidromes “Hot & Bothered” Hyperthermic Toxidromes]

[https://www.ariadnelabs.org/safe-surgery-safe-systems/surgical-safety/or-crisis-checklists/ Ariadne Labs:OR Crisis Checklists]

[https://pediatric-anesthesia.eu/bp_calculator/ Pediatric Anesthesia Calculator]

[https://opencriticalcare.org/wp-content/uploads/2022/04/POCUS_030422.4.20-o1nd2u.pdf POCUS reference card]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/09000/handoff_mnemonics_used_in_perioperative_handoff.5.aspx Handoff Mnemonics Used in Perioperative Handoff Intervention Studies: A Systematic Review]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/09000/checklists,_mnemonics,_and_the_avoidance_of.3.aspx Editorial: Checklists, Mnemonics, and the Avoidance of Cargo-Cult Science]

[https://www.umassmed.edu/link/b12124ee286146a8b963807dc827fc8a/ UMASS Memorial Medical Center Pediatric Anesthesia: A Primer]

[https://www.maskinduction.com/ Tufts Medical Center Pediatric Anesthesia Digital Handbook]

[https://pediatrica.github.io/ Pediatrica Calculator]

File:ACCM Pocket Reference 2023.pdf

2026-10-06T14:29:04Z

WikiSysop:

Post-anesthesia Care Unit

2026-10-06T14:20:06Z

WikiSysop:

{{Stub Notice}}

[https://journals.lww.com/anesthesiology/fulltext/10.1097/aln.0000000000006193~measures-of-quality-of-recovery-and-discharge-readiness Measures of Quality of Recovery and Discharge-readiness Tools in the Pediatric Postanesthesia Care Unit]
:[https://journals.lww.com/anesthesiology/abstract/10.1097/aln.0000000000006270~let-the-children-speak Editirial: Let the Children Speak]

Obesity

2026-10-06T13:38:57Z

WikiSysop:

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[https://www.bjaed.org/article/S2058-5349(22)00007-5/fulltext Obesity in childhood]

[https://pubmed.ncbi.nlm.nih.gov/36622115/ Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity]

[https://pubmed.ncbi.nlm.nih.gov/19690239/ Overweight/obesity and gastric fluid characteristics in pediatric day surgery: implications for fasting guidelines and pulmonary aspiration risk]

[https://pubmed.ncbi.nlm.nih.gov/9768764/ Gastric fluid volume: is it really a risk factor for pulmonary aspiration? Anesthesia and analgesia]

[https://pubmed.ncbi.nlm.nih.gov/21148651/ Dose adjustment of anaesthetics in the morbidly obese]

[https://pubmed.ncbi.nlm.nih.gov/8082507/ Natural history and treatment with ursodiol of gallstones formed during rapid loss of weight in man]

[https://pubmed.ncbi.nlm.nih.gov/34540940/ Excess Body Weight and Gallstone Disease]

[https://pubmed.ncbi.nlm.nih.gov/1858735/ Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity]

[https://www.nejm.org/doi/full/10.1056/NEJMcp2102062 Obesity in Adolescents]

[https://jamanetwork.com/journals/jama/fullarticle/2676543 Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016]

[https://doi.org/10.3945/ajcn.115 Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults]

[https://publications.aap.org/pediatrics/article/151/2/e2022060640/190443/Clinical-Practice-Guideline-for-the-Evaluation-and Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity]

[https://www.nejm.org/doi/full/10.1056/NEJMoa1813909 Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults]

[https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/patients-taking-popular-medications-for-diabetes-and-weight-loss-should-stop-before-elective-surgery American Society of Anesthesiologists. Patients Taking Popular Medications for Diabetes and Weight Loss Should Stop Before Elective Surgery, ASA Suggests]

[https://www.nejm.org/doi/full/10.1056/NEJMoa1916038 A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2208601 Once-Weekly Semaglutide in Adolescents with Obesity]

[https://pubmed.ncbi.nlm.nih.gov/33567185/ STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity]

[https://pubmed.ncbi.nlm.nih.gov/35441470/ STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension]

[https://pubmed.ncbi.nlm.nih.gov/24708463/ A retrospective description of anesthetic medication dosing in overweight and obese children]

[https://europepmc.org/article/med/28258392 Propofol clearance in morbidly obese children and adolescents]

[https://www.scholars.northwestern.edu/en/publications/the-effect-of-obesity-on-the-ed95-of-propofol-for-loss-of-conscio The effect of obesity on the ED(95) of propofol for loss of consciousness in children and adolescents]

[https://pubmed.ncbi.nlm.nih.gov/38100803/ Bolus Dose Administration of Fentanyl in Obese Children: Do Settle for Less]

[https://www.anesthesiologynews.com/Review-Articles/Article/10-25/Obese-Adolescents-and-the-Implications-for-Anesthesiologists/78371 Obese Adolescents and the Implications for Anesthesiologists]

[https://resources.wfsahq.org/atotw/paediatric-obesity-implications-for-anaesthesia/ WFSA: Paediatric Obesity: Implications for Anaesthesia]

Positioning

2026-10-06T12:27:30Z

WikiSysop:

{{Stub Notice}}

[https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0040-1715356.pdf Modified Prone Positioning during Neurosurgery: Sphinx and Concorde Positions Revisited]

[https://pubs.asahq.org/anesthesiology/article/128/1/11/19173/Practice-Advisory-for-the-Prevention-of Practice Advisory for the Prevention of Perioperative Peripheral Neuropathies 2018: An Updated Report by the American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies*]

[https://pubmed.ncbi.nlm.nih.gov/23583045/ Corneal protection during general anesthesia for nonocular surgery]

[https://www.apsf.org/article/perioperative-corneal-abrasions-from-an-ophthalmologists-perspective/ Perioperative Corneal Abrasions from an Ophthalmologist’s Perspective]

[https://www.apsf.org/article/managing-postoperative-corneal-abrasions-a-protocol-for-anesthesiology-teams/ Managing Postoperative Corneal Abrasions: A Protocol for Anesthesiology Teams]

[https://pubs.asahq.org/anesthesiology/article/140/4/805/139919/Operating-Room-Table-Malfunction-Would-You-Know Operating Room Table Malfunction: Would You Know What to Do?]

[https://pubmed.ncbi.nlm.nih.gov/29328794/ Corneal abrasion following anaesthesia for non-ocular surgical procedures: A case-controlled study]

[https://pubmed.ncbi.nlm.nih.gov/29313904/ Peripheral nerve injury arising in anaesthesia practice]

[https://pubmed.ncbi.nlm.nih.gov/29787414/ Perioperative Peripheral Nerve Injury After General Anesthesia: A Qualitative Systematic Review]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00185-X/fulltext Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis]

[https://pubmed.ncbi.nlm.nih.gov/20644490/ Chemical burns associated with chlorhexidine-alcohol solution: an avoidable complication?]

[https://pubmed.ncbi.nlm.nih.gov/19489950/ Echocardiographic diagnosis of right ventricular inflow compression associated with pectus excavatum during spinal fusion in prone position]

[https://pubmed.ncbi.nlm.nih.gov/25893178/ Complications associated with prone positioning in elective spinal surgery]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70081 Incidence of peri-operative peripheral nerve injuries associated with general and regional anaesthesia: an observational study]

Patterson H, Sommerfield D, Sommerfield A, Hauser N, Evans D, Khan RN, von Ungern-Sternberg BS. [https://pubmed.ncbi.nlm.nih.gov/42413820/ Impact of patient positioning on the occurrence of perioperative respiratory adverse events in children -a cluster randomised trial – The POSSUM trial] Anaesth Crit Care Pain Med. 2026 Jul 7;45(6):101889. doi: 10.1016/j.accpm.2026.101889. Epub ahead of print. PMID: 42413820.

Ergonomics and Physical Factors

2026-10-06T04:03:24Z

WikiSysop:

{{Stub Notice}}

[https://www.bjaed.org/article/S2058-5349(22)00010-5/fulltext Reducing musculoskeletal pain in the operating theatre]

[https://www.anesthesiologynews.com/Commentary/Article/01-23/The-Inherent-Hazards-of-Being-an-Anesthesiologist/69079 The Inherent Hazards of Being an Anesthesiologist]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15920 Human factors in anaesthesia: a narrative review]

[https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Syringe%20labelling%202022%20v1.1.pdf?ver=2022-10-26-140938-370 Syringe labelling in anaesthesia and critical care areas: review 2022]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16014 Human factors and medication safety]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16023 Prefilled syringes have significant human factors benefits and would improve anaesthetic medication safety]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15941 Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16036 Implementing human factors in anaesthesia: no man is an island]

[https://www.sciencedirect.com/science/article/abs/pii/S0007091223004257 Lessons from aviation safety: pilot monitoring, the sterile flight deck rule, and aviation-style computerised checklists in the operating room]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00491-9/fulltext Effects of altering harmonic structure on the recognition of simulated auditory arterial pressure alarms]

[https://www.sciencedirect.com/science/article/pii/S1053077012004430 Noise Levels in Modern Operating Rooms During Surgery]

[https://www.asahq.org/standards-and-practice-parameters/statement-on-anesthesiologist-head-injuries-in-anesthetizing-locations ASA’s Statement on Anesthesiologist Head Injuries in Anesthetizing Locations]

[https://journals.lww.com/anesthesiology/fulltext/2025/11000/head_strikes_among_perioperative_personnel_in_the.16.aspx Head Strikes among Perioperative Personnel in the United States: A Mixed-methods Study]

[https://journals.lww.com/anesthesiology/fulltext/2025/11000/one_strike_and_you_re_out_.9.aspx EDITORIAL:One Strike and You’re Out!]

[https://verticalmag-com.cdn.ampproject.org/c/s/verticalmag.com/news/shift-work-and-fatigue-how-to-manipulate-your-sleep-habits-to-boost-performance/amp/ Shift work and fatigue: how to manipulate your sleep habits to boost performance]

[https://www.ovid.com/jnls/anesthesiology/fulltext/10.1097/aln.0000000000006135~clinical-performance-in-critical-care-simulation-under-sleep Clinical Performance in Critical Care Simulation under Sleep Deprivation: Effects of Power Napping in the Recovery Napping Protocol for Anesthesiologist Performance (R-NAP) Randomized Controlled Trial]
:[https://journals.lww.com/anesthesiology/abstract/10.1097/aln.0000000000006232~generating-evidence-for-realistic-fatigue-countermeasures-in Generating Evidence for Realistic Fatigue Countermeasures in Anesthesia]

Ergonomics and Physical Factors

2026-10-06T04:01:09Z

WikiSysop:

{{Stub Notice}}

[https://www.bjaed.org/article/S2058-5349(22)00010-5/fulltext Reducing musculoskeletal pain in the operating theatre]

[https://www.anesthesiologynews.com/Commentary/Article/01-23/The-Inherent-Hazards-of-Being-an-Anesthesiologist/69079 The Inherent Hazards of Being an Anesthesiologist]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15920 Human factors in anaesthesia: a narrative review]

[https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Syringe%20labelling%202022%20v1.1.pdf?ver=2022-10-26-140938-370 Syringe labelling in anaesthesia and critical care areas: review 2022]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16014 Human factors and medication safety]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16023 Prefilled syringes have significant human factors benefits and would improve anaesthetic medication safety]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15941 Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16036 Implementing human factors in anaesthesia: no man is an island]

[https://www.sciencedirect.com/science/article/abs/pii/S0007091223004257 Lessons from aviation safety: pilot monitoring, the sterile flight deck rule, and aviation-style computerised checklists in the operating room]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00491-9/fulltext Effects of altering harmonic structure on the recognition of simulated auditory arterial pressure alarms]

[https://www.sciencedirect.com/science/article/pii/S1053077012004430 Noise Levels in Modern Operating Rooms During Surgery]

[https://www.asahq.org/standards-and-practice-parameters/statement-on-anesthesiologist-head-injuries-in-anesthetizing-locations ASA’s Statement on Anesthesiologist Head Injuries in Anesthetizing Locations]

[https://journals.lww.com/anesthesiology/fulltext/2025/11000/head_strikes_among_perioperative_personnel_in_the.16.aspx Head Strikes among Perioperative Personnel in the United States: A Mixed-methods Study]

[https://journals.lww.com/anesthesiology/fulltext/2025/11000/one_strike_and_you_re_out_.9.aspx EDITORIAL:One Strike and You’re Out!]

[https://verticalmag-com.cdn.ampproject.org/c/s/verticalmag.com/news/shift-work-and-fatigue-how-to-manipulate-your-sleep-habits-to-boost-performance/amp/ Shift work and fatigue: how to manipulate your sleep habits to boost performance]

[https://journals.lww.com/anesthesiology/abstract/10.1097/aln.0000000000006232~generating-evidence-for-realistic-fatigue-countermeasures-in Generating Evidence for Realistic Fatigue Countermeasures in Anesthesia]

Academic Matters

2026-10-05T20:21:07Z

WikiSysop:

{{Stub Notice}}

Joseph V. Simone; [https://aacrjournals.org/clincancerres/article/5/9/2281/287826/Understanding-Academic-Medical-Centers-Simone-s Understanding Academic Medical Centers: Simone’s Maxims.]Clin Cancer Res 1 September 1999; 5 (9): 2281–2285.

Stephanie L. Graff et al. [https://ascopubs.org/doi/full/10.1200/JCO.22.01060 Understanding Modern Medical Centers: Beyond Simone—Intersectional Maxims for a New Era.] J Clin Oncol 41, 1350-1358(2023).
DOI:10.1200/JCO.22.01060

[https://www.nejm.org/doi/full/10.1056/NEJMms2308228 Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training]

[https://www.sciencedirect.com/science/article/pii/S135917892100104X?via%3Dihub The need for domination in psychopathic leadership: A clarification for the estimated high prevalence of psychopathic leaders]

[https://www.bjanaesthesia.org/article/S0007-0912%2824%2900490-2/fulltext Authorship misconduct: professional misconduct in editorial handling of authorship]
[https://www.bjanaesthesia.org/article/S0007-0912%2824%2900713-X/fulltext Comment]

[https://link.springer.com/article/10.1007/s12630-025-03021-2 Beyond misconduct: forging an ethical future in academia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16629 Culture of excellence or culture of control?]

[https://www.sciencedirect.com/science/article/pii/S2772609625001492 Moral injury in clinical and academic medicine—it is time to act]

Academic Matters

2026-10-04T19:55:49Z

WikiSysop:

{{Stub Notice}}

Joseph V. Simone; [https://aacrjournals.org/clincancerres/article/5/9/2281/287826/Understanding-Academic-Medical-Centers-Simone-s Understanding Academic Medical Centers: Simone’s Maxims.]Clin Cancer Res 1 September 1999; 5 (9): 2281–2285.

[https://ascopubs.org/doi/full/10.1200/JCO.22.01060 Understanding Modern Medical Centers: Beyond Simone—Intersectional Maxims for a New Era]

[https://www.nejm.org/doi/full/10.1056/NEJMms2308228 Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training]

[https://www.sciencedirect.com/science/article/pii/S135917892100104X?via%3Dihub The need for domination in psychopathic leadership: A clarification for the estimated high prevalence of psychopathic leaders]

[https://www.bjanaesthesia.org/article/S0007-0912%2824%2900490-2/fulltext Authorship misconduct: professional misconduct in editorial handling of authorship]
[https://www.bjanaesthesia.org/article/S0007-0912%2824%2900713-X/fulltext Comment]

[https://link.springer.com/article/10.1007/s12630-025-03021-2 Beyond misconduct: forging an ethical future in academia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16629 Culture of excellence or culture of control?]

[https://www.sciencedirect.com/science/article/pii/S2772609625001492 Moral injury in clinical and academic medicine—it is time to act]

Depth of Anesthesia

2026-10-04T12:35:45Z

WikiSysop: /* Intraoperative monitoring */

== Introduction ==
General anesthesia is a medically induced state of unresponsiveness and unconsciousness. This state facilitates the safe and effective conduct of surgical procedures. The ability to assess adequate sedation is of utmost importance to get patients through surgery safely. In 1937, Dr. Arthur Guedel described the stages of anesthesia, providing a framework of clinical signs and typical behaviors that allow the anesthesiologist to reliably determine their patients' depth of sedation. These stages were described using ether as the primary anesthetic. Although ether is no longer used, the classification is still pertinent to modern anesthesia practice.

==Anesthesia stages (Guedel's classification)<ref>Atkison, R.S., Rushman, G. B., Lee, J. Alfred, A synopsis of anaesthesia</ref>==
[[File:Image01.jpg|thumb|Guedel’s stages of anesthesia]]

Stage 1: Analgesia or disorientation

This stage is marked by the preoperative anesthesia state to unconsciousness. During this stage, the patient may be sedated but still conversational and conscious. It can be described as the "induction stage" or the "disorientation stage", in which respirations are slow and regular, eye movement is voluntary, and muscular tone is normal.

Stage 2: Excitement or Uninhibited response

In this stage, the patient may present with tense struggling, vomiting, breath holding, coughing and swallowing. Airway reflexes remain intact during this phase, and can be hypersensitive to manipulation. Therefore, manipulation of airway (placement or removal of endotracheal tubes, suctioning) should be avoided, in order to prevent laryngospasm. This stage is characterized by loss of eyelash reflex and outward movement of the eye. This stage can be minimized with fast acting agents, psychological preparation of patient and quiet surroundings.

Stage 3: Surgical anesthesia

This stage starts with mechanical ventilation and respiratory paralysis. It is marked by decreased response to surgical incision. Guedel has divided this stage into four planes:

- Plane 1: from onset of automatic respiration to cessation of eye movement. Eyelid, conjunctival and swallow reflexes disappear.

- Plane 2: from cessation of eye movement to start of intercostal paralysis. Corneal and laryngeal reflexes disappear. Increased lacrimation may occur.

- Plane 3: from start of intercostal paralysis to complete paralysis. Pupillary light reflex disappears. This plane is referred as the "true surgical anesthesia", in which the response to incision is minimal.

- Plane 4: from complete intercostal paralysis to diaphragmatic paralysis. Apnea.

Stage 4: Overdosage

This stage is marked by apnea and loss of all reflexes, and may lead to death. Cardiovascular and respiratory support are necessary in this stage. Pupils are widely dilated due to increased levels of adrenaline. Maximum dilation is characterized by anoxia and paralysis of the sphincter.

==Awareness during anesthesia==

Awareness during general anesthesia occurs when depth of anesthesia is inadequate to achieve a state of unconsciousness.<ref>Intraoperative and Anesthesia Awareness [https://www.ncbi.nlm.nih.gov/books/NBK582138/#:~:text=Awareness%20under%20anesthesia%20is%20a,achieve%20a%20state%20of%20unconsciousness. https://www.ncbi.nlm.nih.gov/books/NBK582138/#:~:text=Awareness%20under%20anesthesia%20is%20a,achieve%20a%20state%20of%20unconsciousness.]</ref> It is characterized by recall of events during surgery, ranging from auditory to painful stimulation memories. The incidence ranges from 1:1,000 to 1:20,000,<ref>Sebel PS, Bowdle TA, Ghoneim MM, Rampil IJ, Padilla RE, Gan TJ, Domino KB. The incidence of awareness during anesthesia: a multicenter United States study. Anesth Analg. 2004 Sep;99(3):833-839</ref> being difficult to assess due to investigation dependent incidence. It is most common during induction and emergence of general anesthesia.

There are some risk factors that may contribute to this complication, and they are related to:

''Anesthesia technique:''
*use of neuromuscular blockade medications (decreased perception of awareness when patient is paralysed)
*total intravenous anesthesia (TIVA) - (human error, pump or IV defect)
''Surgical procedure:''
*emergency surgery (hemodinamic instability that reduces delivery of anesthetic, lower dosage of anesthetics)
*emergency cesarian section (lower dosage of anesthetics and inadequate delivery of anesthetic because of rapid incision)
*difficult airway placement (volatile agents may not be delivered until placement of definitive airway)
*cardiopulmonary bypass (altered physiology and volatile agents are stopped)
''Patient'':
*history of awareness
*genetic resistance to anesthetics
*chronic substance abuse (resistance to anesthetics)
*obese
*congestive heart failure or significant valvular disease (reduction of dosage of anesthetics)

== Intraoperative monitoring ==
'''Clinical features:'''

Heart rate, blood pressure, purposeful movement and end tidal anesthetic concentration (ETAC) may be useful in recognizing awareness during general anesthesia. However, some drugs may mask these signs (calcium channel blockers, neuromuscular blockers).

'''Bispectral index ([[BIS]]):'''

Processed EEG monitor, translating EEG waves into a numeric scale ranging from 0 (complete EEG suppression) to 100 (fully awake). It is said that adequate anesthesia may be present with a BIS value of 40-60. Studies have shown that intraoperative BIS, compared to clinical signs, may have a reduction of intraoperative awareness (OR) 0.36, 95% CI 0.21 to 0.60; I2 = 61%; 27 studies; 9765 participants<ref name=":0">https://pubmed.ncbi.nlm.nih.gov/31557307/</ref>, time to eye opening, time to orientation, and time to discharge patient from PACU<ref name=":0" />. However, BIS guided anesthesia did not show a clinical difference to anesthesia guided by end tidal anesthetic gas concentration (ETAC). Furthermore, studies show that neuromuscular blockade alone, without other anesthetics, decrease the value of BIS.<ref>Schuller PJ, Newell S, Strickland PA, Barry JJ. Response of bispectral index to neuromuscular block in awake volunteers. Br J Anaesth. 2015 Jul;115 Suppl 1:i95-i103.</ref> Therefore, the accuracy and reliability of BIS are questionable.

'''[[SEDline]]®:'''

Processed EEG monitor. The PSI (Patient State Index) translates the effect of anesthetic drugs in humans into a numeric scale ranging from 0 (complete EEG suppression) to 100 (fully awake). The target value for general anesthesia is between 25-50. A study showed that this monitor better captured changes in brain state from dexmedetomidine sedation, compared to RASS score and SEF95<ref>EEG response of dexmedetomidine during drug induced sleep endoscopy https://pubmed.ncbi.nlm.nih.gov/37521700/</ref>. Another study suggests that PSI may be adequate to monitor anesthesia with sevoflurane in the pediatric population, when compared to the BIS monitor<ref>Usefulness of bispectral index and patient state index during sevoflurane anesthesia in children: A prospective observational study

Relevant Article Depot:

[https://journals.lww.com/md-journal/pages/articleviewer.aspx?year=2022&issue=07290&article=00027&type=Fulltext Usefulness of bispectral index and patient state index during sevoflurane anesthesia in children: A prospective observational study]

[https://www.openanesthesia.org/keywords/stages-of-anesthesia/ Open Anesthesia: Stages of Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/19598725/ A Re-evaluation of Guedel's Stages of Anesthesia: With particular reference to the ambulatory dental general anesthetic patient]

[https://pubmed.ncbi.nlm.nih.gov/15172773/ Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial]

[https://pubmed.ncbi.nlm.nih.gov/31557307/ Bispectral index for improving intraoperative awareness and early postoperative recovery in adults]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00473-7/fulltext Depth of anaesthesia monitoring: updated evidence. Comment]

[https://pubmed.ncbi.nlm.nih.gov/37198033/ Depth of anaesthesia monitoring: time to reject the index?] [https://www.sciencedirect.com/science/article/pii/S0007091223006311 Depth of amnesia monitoring. Response to Br J Anaesth 2023; 131: e145–7]

[https://www.ncbi.nlm.nih.gov/books/NBK557596/ StatPearls: Anesthesia Stages]

[https://pubs.asahq.org/anesthesiology/article/140/2/313/139650/Consciousness-and-General-Anesthesia-Challenges Consciousness and General Anesthesia: Challenges for Measuring the Depth of Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/21971394/ Limitations of anaesthesia depth monitoring]

[https://academic.oup.com/bja/article-abstract/115/suppl_1/i46/234305?redirectedFrom=fulltext The Ageing Brain: Age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia]

[https://pubmed.ncbi.nlm.nih.gov/26174303/ Age-dependency of sevoflurane-induced electroencephalogram dynamics in children]

[https://pubs.asahq.org/anesthesiology/article/140/5/863/140017/A-Window-into-the-Developing-Brain-Toward-a-Deeper A Window into the Developing Brain: Toward a Deeper Understanding of Pediatric Anesthesia]

[https://www.sciencedirect.com/science/article/pii/S1932227521000355 Depth of Anesthesia Monitoring]

[https://journals.lww.com/anesthesiology/fulltext/2024/02000/consciousness_and_general_anesthesia__challenges.24.aspx Consciousness and General Anesthesia: Challenges for Measuring the Depth of Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/27059416/ Accidental awareness during anesthesia in children]

==References==

The child of a Jehovah's Witness

2026-10-03T19:29:06Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/8720890/ Anesthesia and intensive care management of severely burned children of Jehovah's Witnesses]

[https://pubmed.ncbi.nlm.nih.gov/33900586/ Perioperative blood conservation strategies for pediatric scoliosis surgery]

[https://pubmed.ncbi.nlm.nih.gov/27224036/ Transfusion-Free Calvarial Vault Reconstruction Using Multimodal Blood Conservation Strategies in Two Pediatric Jehovah's Witness Patients With Craniosynostosis]

[https://apnews.com/article/jehovahs-witnesses-blood-transfusion-policy-change-3b01d3b095fe895a131633192a774e17 APNews: Jehovah’s Witnesses ease policy on transfusions, allowing storage and use of one’s own blood (March 20, 2026)]

[https://apnews.com/article/jehovahs-witnesses-donated-blood-transfusions-plasma-13fbe733e0039109efa728f65c7e4fda APNews: Jehovah’s Witnesses allow blood-derived products but keep ban on whole-blood transfusions (September 18, 2026)]

The child of a Jehovah's Witness

2026-10-03T19:28:23Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/8720890/ Anesthesia and intensive care management of severely burned children of Jehovah's Witnesses]

[https://pubmed.ncbi.nlm.nih.gov/33900586/ Perioperative blood conservation strategies for pediatric scoliosis surgery]

[https://pubmed.ncbi.nlm.nih.gov/27224036/ Transfusion-Free Calvarial Vault Reconstruction Using Multimodal Blood Conservation Strategies in Two Pediatric Jehovah's Witness Patients With Craniosynostosis]

[https://apnews.com/article/jehovahs-witnesses-blood-transfusion-policy-change-3b01d3b095fe895a131633192a774e17 APNews: Jehovah’s Witnesses ease policy on transfusions, allowing storage and use of one’s own blood]

[https://apnews.com/article/jehovahs-witnesses-donated-blood-transfusions-plasma-13fbe733e0039109efa728f65c7e4fda APNews: Jehovah’s Witnesses allow blood-derived products but keep ban on whole-blood transfusions (September 18, 2026)]

The child of a Jehovah's Witness

2026-10-03T19:26:17Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/8720890/ Anesthesia and intensive care management of severely burned children of Jehovah's Witnesses]

[https://pubmed.ncbi.nlm.nih.gov/33900586/ Perioperative blood conservation strategies for pediatric scoliosis surgery]

[https://pubmed.ncbi.nlm.nih.gov/27224036/ Transfusion-Free Calvarial Vault Reconstruction Using Multimodal Blood Conservation Strategies in Two Pediatric Jehovah's Witness Patients With Craniosynostosis]

[https://apnews.com/article/jehovahs-witnesses-blood-transfusion-policy-change-3b01d3b095fe895a131633192a774e17 APNews: Jehovah’s Witnesses ease policy on transfusions, allowing storage and use of one’s own blood]

[https://apnews.com/article/jehovahs-witnesses-donated-blood-transfusions-plasma-13fbe733e0039109efa728f65c7e4fda Jehovah’s Witnesses allow blood-derived products but keep ban on whole-blood transfusions]

Thyroglossal Duct Cyst

2026-10-03T12:22:55Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/20956901/ Sistrunk's operation for the treatment of thyroglossal cyst]

[https://pubmed.ncbi.nlm.nih.gov/37651810/ Thyroglossal duct cyst on the suprasternal region: An extremely unusual location]

[https://pubmed.ncbi.nlm.nih.gov/39156061/ Thyroglossal duct cyst in the superior mediastinum]

[https://pubmed.ncbi.nlm.nih.gov/37685512/ Ultrasound-Guided Ethanol Ablation for Thyroglossal Duct Cyst: A Review of Technical Issues and Potential as a New Standard Treatment]

[https://pubmed.ncbi.nlm.nih.gov/36474396/ Use of Bilateral Superficial Cervical Plexus Block for Excision of Thyroglossal Duct Cyst in an ASA III Patient]

[https://www.nejm.org/doi/full/10.1056/NEJMicm2607953 Thyroglossal Duct Cyst]

Superficial Cervical Plexus Block

2026-10-02T15:39:16Z

WikiSysop:

{{Stub Notice}}

Tobias JD. [https://pubmed.ncbi.nlm.nih.gov/10624648/ Cervical plexus block in adolescents.] J Clin Anesth. 1999 Nov;11(7):606-8. doi: 10.1016/s0952-8180(99)00104-x. PMID: 10624648.

Prigge L, Bosenberg AT, van Schoor AN. [https://pubmed.ncbi.nlm.nih.gov/40866302/ Anatomical study of the superficial cervical plexus targeted for sensory nerve blocks in neonates.] Reg Anesth Pain Med. 2026 Aug 5;51(8):954-958. doi: 10.1136/rapm-2025-106997. PMID: 40866302.

Superficial Cervical Plexus Block

2026-10-02T15:38:12Z

WikiSysop:

{{Stub Notice}}

Tobias JD. [https://pubmed.ncbi.nlm.nih.gov/10624648/ Cervical plexus block in adolescents.] J Clin Anesth. 1999 Nov;11(7):606-8. doi: 10.1016/s0952-8180(99)00104-x. PMID: 10624648.

Factors that Modulate Pediatric Pain

2026-10-01T19:44:08Z

WikiSysop:

{{Stub_Notice}}

[https://pubmed.ncbi.nlm.nih.gov/31896130/ The influence of pain, agitation, and their management on the immature brain]

[https://pubmed.ncbi.nlm.nih.gov/32023375/ Placebo and nocebo effects]

[https://pubmed.ncbi.nlm.nih.gov/17977860/ Effect of communication on pain during intravenous cannulation: a randomized controlled trial]

[https://pubmed.ncbi.nlm.nih.gov/20042440/ Nocebo-induced hyperalgesia during local anesthetic injection]

[https://pubmed.ncbi.nlm.nih.gov/17108175/ The biochemical and neuroendocrine bases of the hyperalgesia nocebo effect]

[https://pubmed.ncbi.nlm.nih.gov/17379417/ When words are painful: unraveling the mechanisms of the nocebo effect]

[https://pubmed.ncbi.nlm.nih.gov/25663166/ “This may hurt”: predictors in procedural disclosures may do harm]

[https://pubmed.ncbi.nlm.nih.gov/25663166/ Guidelines on informed consent in anaesthesia: unrealistic, unethical, untenable]

[https://pubmed.ncbi.nlm.nih.gov/31036258/ Parental understanding of their child’s risk of anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/35001386/ Implications of nocebo in anaesthesia care]

[https://www.bjanaesthesia.org/article/S0007-0912(22)00515-3/fulltext Efficacy of preemptive analgesia treatments for the management of postoperative pain: a network meta-analysis]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240401/ Prevalence of chronic pain in children and adolescents with psychiatric conditions]

[https://pubmed.ncbi.nlm.nih.gov/24641344/ Early repetitive pain in preterm infants in relation to the developing brain]

[https://pubmed.ncbi.nlm.nih.gov/22374882/ Procedural pain and brain development in premature newborns]

[https://pubmed.ncbi.nlm.nih.gov/18594041/ Epidemiology and treatment of painful procedures in neonates in intensive care units]

[https://pubmed.ncbi.nlm.nih.gov/16777824/ Summary proceedings from the neonatal pain-control group]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/perioperative_regional_anesthesia_on_persistent.928.aspx Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]

[https://pubmed.ncbi.nlm.nih.gov/38670899/ Comparison of postoperative pain in children after maintenance anaesthesia with propofol or sevoflurane: a systematic review and meta-analysis]

Alderman EM, Breuner CC, COMMITTEE ON ADOLESCENCE, et al. [https://pubmed.ncbi.nlm.nih.gov/31740496/ Unique Needs of the Adolescent.] Pediatrics. 2019;144(6):e20193150. doi:10.1542/peds.2019-3150

Harbaugh CM, Lee JS, Hu HM, et al. Persistent Opioid Use Among Pediatric Patients After Surgery. Pediatrics. 2018;141(1):e20172439. doi:10.1542/peds.2017-2439

O’Brien E, Muhly WT, Kallan MJ, Sutherland TN. [https://pubmed.ncbi.nlm.nih.gov/29203521/ High levels of persistent pain among adolescents recovering from anterior cruciate ligament reconstruction: a single-center cohort study.] Reg Anesth Pain Med. Published online April 15, 2026:rapm-2025-107537. doi:10.1136/rapm-2025-107537

Helenius L, Yrjälä T, Oksanen H, et al. [https://pubmed.ncbi.nlm.nih.gov/34424869/ Pregabalin and Persistent Postoperative Pain Following Posterior Spinal Fusion in Children and Adolescents: A Randomized Clinical Trial.] J Bone Joint Surg Am. 2021;103(23):2200-2206. doi:10.2106/JBJS.21.00153

Ellyson AM, Gordon G, Zhou C, Rabbitts JA. [https://pubmed.ncbi.nlm.nih.gov/34974171/ Trajectories, Risk Factors, and Impact of Persistent Pain After Major Musculoskeletal Surgery in Adolescents: A Replication Study.] J Pain. 2022;23(6):995-1005. doi:10.1016/j.jpain.2021.12.009

Rosenbloom BN, Frederiksen SD, Wang V, et al. [https://pubmed.ncbi.nlm.nih.gov/39909544/ Prognostic factors of chronic postsurgical pain in children and adolescents: a systematic review and meta-analysis.] Reg Anesth Pain Med. 2025;50(2):144-152. doi:10.1136/rapm-2024-105696

Rosenbloom BN, Pagé MG, Isaac L, et al. [https://pubmed.ncbi.nlm.nih.gov/31814752/ Pediatric Chronic Postsurgical Pain And Functional Disability: A Prospective Study Of Risk Factors Up To One Year After Major Surgery.] J Pain Res. 2019;12:3079-3098. doi:10.2147/JPR.S210594

Sutherland TN, Hadland SE, Moon J, et al. [https://pubmed.ncbi.nlm.nih.gov/41142590/ The Adolescent Surgery Experience (ASE): a survey-based prospective cohort study to measure risk factors for persistent opioid use.] BJA Open. 2025;16:100496. doi:10.1016/j.bjao.2025.100496

Factors that Modulate Pediatric Pain

2026-10-01T19:40:00Z

WikiSysop:

{{Stub_Notice}}

[https://pubmed.ncbi.nlm.nih.gov/31896130/ The influence of pain, agitation, and their management on the immature brain]

[https://pubmed.ncbi.nlm.nih.gov/32023375/ Placebo and nocebo effects]

[https://pubmed.ncbi.nlm.nih.gov/17977860/ Effect of communication on pain during intravenous cannulation: a randomized controlled trial]

[https://pubmed.ncbi.nlm.nih.gov/20042440/ Nocebo-induced hyperalgesia during local anesthetic injection]

[https://pubmed.ncbi.nlm.nih.gov/17108175/ The biochemical and neuroendocrine bases of the hyperalgesia nocebo effect]

[https://pubmed.ncbi.nlm.nih.gov/17379417/ When words are painful: unraveling the mechanisms of the nocebo effect]

[https://pubmed.ncbi.nlm.nih.gov/25663166/ “This may hurt”: predictors in procedural disclosures may do harm]

[https://pubmed.ncbi.nlm.nih.gov/25663166/ Guidelines on informed consent in anaesthesia: unrealistic, unethical, untenable]

[https://pubmed.ncbi.nlm.nih.gov/31036258/ Parental understanding of their child’s risk of anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/35001386/ Implications of nocebo in anaesthesia care]

[https://www.bjanaesthesia.org/article/S0007-0912(22)00515-3/fulltext Efficacy of preemptive analgesia treatments for the management of postoperative pain: a network meta-analysis]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240401/ Prevalence of chronic pain in children and adolescents with psychiatric conditions]

[https://pubmed.ncbi.nlm.nih.gov/24641344/ Early repetitive pain in preterm infants in relation to the developing brain]

[https://pubmed.ncbi.nlm.nih.gov/22374882/ Procedural pain and brain development in premature newborns]

[https://pubmed.ncbi.nlm.nih.gov/18594041/ Epidemiology and treatment of painful procedures in neonates in intensive care units]

[https://pubmed.ncbi.nlm.nih.gov/16777824/ Summary proceedings from the neonatal pain-control group]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/perioperative_regional_anesthesia_on_persistent.928.aspx Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]

[https://pubmed.ncbi.nlm.nih.gov/38670899/ Comparison of postoperative pain in children after maintenance anaesthesia with propofol or sevoflurane: a systematic review and meta-analysis]

Alderman EM, Breuner CC, COMMITTEE ON ADOLESCENCE, et al. Unique Needs of the Adolescent. Pediatrics. 2019;144(6):e20193150. doi:10.1542/peds.2019-3150

Harbaugh CM, Lee JS, Hu HM, et al. Persistent Opioid Use Among Pediatric Patients After Surgery. Pediatrics. 2018;141(1):e20172439. doi:10.1542/peds.2017-2439

O’Brien E, Muhly WT, Kallan MJ, Sutherland TN. High levels of persistent pain among adolescents recovering from anterior cruciate ligament reconstruction: a single-center cohort study. Reg Anesth Pain Med. Published online April 15, 2026:rapm-2025-107537. doi:10.1136/rapm-2025-107537

Helenius L, Yrjälä T, Oksanen H, et al. Pregabalin and Persistent Postoperative Pain Following Posterior Spinal Fusion in Children and Adolescents: A Randomized Clinical Trial. J Bone Joint Surg Am. 2021;103(23):2200-2206. doi:10.2106/JBJS.21.00153

Ellyson AM, Gordon G, Zhou C, Rabbitts JA. Trajectories, Risk Factors, and Impact of Persistent Pain After Major Musculoskeletal Surgery in Adolescents: A Replication Study. J Pain. 2022;23(6):995-1005. doi:10.1016/j.jpain.2021.12.009

Rosenbloom BN, Frederiksen SD, Wang V, et al. Prognostic factors of chronic postsurgical pain in children and adolescents: a systematic review and meta-analysis. Reg Anesth Pain Med. 2025;50(2):144-152. doi:10.1136/rapm-2024-105696

Rosenbloom BN, Pagé MG, Isaac L, et al. Pediatric Chronic Postsurgical Pain And Functional Disability: A Prospective Study Of Risk Factors Up To One Year After Major Surgery. J Pain Res. 2019;12:3079-3098. doi:10.2147/JPR.S210594

Sutherland TN, Hadland SE, Moon J, et al. The Adolescent Surgery Experience (ASE): a survey-based prospective cohort study to measure risk factors for persistent opioid use. BJA Open. 2025;16:100496. doi:10.1016/j.bjao.2025.100496

Positioning

2026-10-01T12:59:45Z

WikiSysop:

MCI Action List

2026-09-30T12:15:05Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|ZBOR Lead Anesthesia Tech
|667-208-3336
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::Keep in
::Call in
::Standby
::Reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::Changing time-line
::Incoming patients (numbers, types of injuries)
::Changing needs assessment
::Revised estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (Oxygen)
::Bleeding (Tourniquet)
::Thorax (Chest tube)
::Poisoning (Antidote)

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

=== Release excess staff home ===

=== Resume elective procedures again ===

=== Refresh new staff ===

=== De-escalate security ===

=== Restock supplies ===

=== Laundry/Room Flips ===

MCI Action List

2026-09-30T02:34:43Z

WikiSysop: /* Triage + Treat Patients */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::Keep in
::Call in
::Standby
::Reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::Changing time-line
::Incoming patients (numbers, types of injuries)
::Changing needs assessment
::Revised estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (Oxygen)
::Bleeding (Tourniquet)
::Thorax (Chest tube)
::Poisoning (Antidote)

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

=== Release excess staff home ===

=== Resume elective procedures again ===

=== Refresh new staff ===

=== De-escalate security ===

=== Restock supplies ===

=== Laundry/Room Flips ===

MCI Action List

2026-09-30T02:32:30Z

WikiSysop: /* STAGE 2 (RAMP UP) GOALS */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::Keep in
::Call in
::Standby
::Reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::Changing time-line
::Incoming patients (numbers, types of injuries)
::Changing needs assessment
::Revised estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

=== Release excess staff home ===

=== Resume elective procedures again ===

=== Refresh new staff ===

=== De-escalate security ===

=== Restock supplies ===

=== Laundry/Room Flips ===

Main Page

2026-09-30T02:22:02Z

WikiSysop: /* Basic Clinical Information [Outside Sources] */

[[File:Apple-icon.png|left|60x60px|link=https://pedsanesthesia.net/wiki/index.php]]

[[File:JoinTeam-500x350.png|right|frameless|190x190px|alt=| link=https://pedsanesthesia.net/wiki/index.php?title=Special:CreateAccount&returnto=Main+Page]]
'''If you are interested in participating in this huge, Global project, please go ahead and [https://pedsanesthesia.net/wiki/index.php?title=Special:CreateAccount&returnto=Main+Page register]! If you are reluctant, please contact me [mailto:DrBobGreenberg@PedsAnesthesia.net here] or on the [https://pedsanesthesia.net/forum forum]. Authorship may be recognized by your institution and contribute to "published works" for academic promotion.'''

----

=Introductory Topics=
:[[Preface]]
:[[Disclaimer]]

:[[The Editing Team]]
:[[History of Pediatric Anesthesia]]
:[[Pediatric Anesthesia Worldwide]]
:[[Measuring Outcome in Pediatric Anesthesia]]
:[[Basic Pediatric Concepts]]

==Training/Education/Certification==
:[[The Making of a Pediatric Anesthesiologist]]
::[[Educational Principles]]
::[[Certification Processes]]
::[[The Anesthesia Workforce]]
::[[Transitioning to Practice]]
::[[Women in Anesthesia]]
::[[Transitioning to Retirement]]
:[[Certified Registered Nurse Anesthestists - CRNA]]
:[[Anaesthesia Associates - AA]]
:[[TYK About | Test Your Knowledge]]
:[[Managing Knowledge]]

==Basic Clinical Information [Outside Sources]==
:[[WFSA PaedsUpdateContents_30]] Volume 30 - June 2015 (Wiki Format)
:[[WFSA PaedsUpdateContents_37]] Volume 37 - October 2023 (Wiki Format) [https://www.dropbox.com/scl/fi/rdgiam3tv8jbzrsptdyoy/New-Update-37-Paediatrics.pdf?rlkey=unpir1ysnmx1xchwq7c3i0oxc&st=ttapqkxn&dl=0 (PDF Format)]
:[[WFSA PaedsUpdateContents_39]] [https://www.dropbox.com/scl/fi/he3ncg2uhwzdi91xh76ta/UIA-39-WORKFORCE-WELL-BEING.pdf?rlkey=y3alw1rxs7telzfdqjtadu6m7&st=y6gxzslh&dl=0 (PDF Format)]
:[https://www2.pedsanesthesia.org/lecture_series/ Society for Pediatric Anesthesia Lecture Series]
:[https://pedsanesthesia.org/spa-one-pagers/ Society for Pediatric Anesthesia "One-Pagers"]
:[https://www.openanesthesia.org/ OpenAnesthesia]
:[https://learn.openpediatrics.org/pages/245/anesthesiology OpenPediatrics for Anesthesiology]
:[https://www.dropbox.com/scl/fi/uwlezdgx26ci6eddhnnba/Pediatric_20y_Comprehensive_Board_Review_-2015.pdf?rlkey=00d46xm9o68t7y4r8l0v35eu5&st=927c5vgv&dl=0 Pediatric Anesthesiology Comprehensive Board Review (Oxford)]
:ASA🔒 Resident Study Guides
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=123 Peds Core Month One Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=134 Peds Core Month 2 Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=137 Peds Advanced Month 3 Curriculum]
:[[ABA Pediatric Anesthesiology Exam Content Outline]]

Textbooks
:[https://www.academia.edu/37973952/Manual_of_Pediatric_Anesthesia 📒 Practice of Anesthesia for Infants and Children, Seventh Edition (Lerman, Coté, Anderson)]

:[https://www.sciencedirect.com/book/9780323341257/smiths-anesthesia-for-infants-and-children 📒 Smith's Anesthesia for Infants and Children • Ninth Edition • 2017 (Davis and Cladis)]

:[https://monographs.ufs.ac.za/index.php/PASA/index 📒 Paediatric Anaesthesia for Southern Africa]

==The Growing Child==
:[[Embryology]]
:[[Development]]
:[[Growth]]
:[[Developmental Psychology]]

==Anatomy & Physiology==
:[[Respiratory System]]
:[[Cardiovascular System]]
:[[Renal System]]
:[[Endocrine System]]
:[[Nervous System]]
:[[Temperature Regulation]]
:[[Fluid & Electrolytes]]
:[[Coagulation & Bleeding]]
:[[Pharmacology]]
::[[Clinical Pharmacokinetics & Pharmacodynamics in children]]
::[[Anesthetic Agents]]
::[[Opiates & Sedatives]]
::[[Muscle Relaxants]]
:[[Epigenetics]]
:[[Infection Control]]
:[[Neurocognitive Risk]]

==Monitoring==
:[[Standard Monitoring]]
::[[Precordial Stethoscope]]
::[[Oxygen]]
::[[Electrocardiography - EKG]]
::[[Carbon Dioxide]]
::[[Blood Pressure]]
::[[Neuromuscular Blockade]]
::[[Temperature]]
:[[Neuromonitoring - IOM]]
:[[Thromboelastography - TEG]]
:[[Pacemakers]]
:[[Automated Internal Defibrillators]]
:[[Near-Infrared Spectroscopy]]
:[[Electroencephalography - EEG]]
:[[Precordial Doppler]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]
:[[Alarm Fatigue]]

==Ethical Issues in Pediatric Anesthesia==
:[[Ethical Constructs relevant to Pediatric Anesthesia]]
:[[The Emancipated Minor]]
:[[Assent/Consent]]
:[[The child of a Jehovah's Witness]]
:[[Anesthesia in Low Resource Settings]]
:[[Global Pediatric Anesthesia]]
:[[VIP Care]]
:[[End of Life]]
:[[Racial Disparities in Care]]
:[[Child Abuse, Neglect, and Protection]]

==Error, Judgement, and The Law==
:[[Errors in the Operating Room]]
::[[Wrong Side Procedures]]
:[[Just Culture]]
:[[The Making of Medical Malpractice Suit]]

=Clinical Techniques=
:[[Standards of Anesthesia]]
:[[Pocket Reference Cards]]
:[[Point of Care Ultrasound - POCUS]]
:[[Hypnosis]]
==Preoperative Assessment==
:[[General Preoperative Assessment]]
:[[Psychological Preparation of the Pediatric Patient & Family]]
:[[The Fetus]]
:[[The Pre-Term Infant]]
:[[The Infant]]
:[[The Child]]
:[[The Adolescent]]
:[[The Adult-aged Pediatric Patient]]
:[[The Former Premature Patient]]
:[[Upper Respiratory Infection]]
:[[Obstructive Sleep Apnea]]
:[[Preoperative Fasting]]
:[[Vaccination Status]]
:[[Child Trafficking]]
:[[Pregnancy Testing]]
:[[Social Determinants of Care]]
:[[Herbal Supplements]]

==Pre-anesthetic Medication==
:[[Pre-induction/Pre-medication]]

==Pediatric Sedation==
:[[Principles of Sedation]]
:[[Dental Sedation]]
:[[Sedation for Radiologic Procedures]]

==Ambulatory Anesthesia==
:[[Criteria for Outpatient Care]]
:[[Facility Requirements for Outpatient Care]]
:[[Risks/Advantages of Outpatient Care]]

==Anesthetic Induction==
:[[Physiology of Anesthesia]]
:[[Parental Presence During Induction]]
:[[Magic as a Distraction Technique]]
:[[Distracting Devices]]
:[[Psychological Preparation of the Pediatric Patient & Family]]

==Maintenance of Anesthesia==
:[[Fluid Management]]
:[[Neuromuscular Blockade]]
:[[Blood Products]]
::[[Massive Transfusion/Hemorrhage Protocol]]
::[[Reducing Blood Draw Anemia]]
::[[Blood Rheology]]
:[[Temperature Management]]
:[[Positioning]]
:[[Ventilation]]
::[[Breathing circuits]]
::[[Intraoperative Atelectasis]]
:[[Hypotension]]
::[[Controlled Hypotension]]
:[[Electrocautery]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]
::[[Dreaming under Anesthesia]]

Drugs
:[[Volatile Anesthetics]]
::[[Inhalational Induction]]
::[[Closed Circuit Anesthesia]]
::[[High Altitude Effects]]
:[[Propofol]]
:[[Ciprofol]]
:[[Dexmedetomidine]]
:[[Opiates]]
:[[Opioid Free Techniques]]
:[[Target Controlled Infusion - TCI]]
:[[Hypnosis]]
:[[Non-Steroidal Anti-inflammatory Agents]]
::[[Ketorolac]]
::[[Ibuprofen]]
::[[Cox-2 Inhibitors]]
:[[Ketamine]]
:[[Esmolol]]
:[[Adenosine]]
:[[Benzodiazepines]]
:[[Perioperative Steroids]]
:[[Antibiotics]]
:[[Acetaminophen]]
:[[Methylene Blue]]
:[[Insulin Pumps]]
:[[Parasympatholytics]]
:[[Bicarbonate]]
:[[Succinylcholine]]
:[[Antihistamines]]
:[[Rubber Coring]]

==Emergence/Recovery from Anesthesia==
:[[Deep Extubation]]
:[[Emergence Delirium]]
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post Obstructive Pulmonary Edema]]
:[[Intraoperative Awareness and Recall]]
:[[Post Operative Apnea]]
:[[Early Mobilization]]
:[[Post-Operative Nursing Care]]
:[[Delayed Emergence]]
:[[Post-Operative Behavior Changes]]

==Airway Management==
:[[Basic Airway Anatomy of the Pediatric Patient]]
:[[Syndromes and Airway Assessment]]
:[[Basic Airway Management of the Pediatric Patient]]
:[[Laryngeal Mask Airway]]
:[[Basic Laryngoscopy and Intubation]]
:[[Basic Nasal Intubation]]

:[[Rapid Sequence Induction]]

:[[Recognizing and Managing the Difficult Pediatric Airway]]

:[[Advanced Airway Techniques]]
:[[Airway POCUS]]

:[[Difficult Airway Response Teams]]
:[[One Lung Ventilation]]
:[[Cuffed vs Uncuffed ETTs]]

:[[Basic Ventilation]]
:[[Advanced Ventilation]]
:[[Emergency Airway Management]]
:[[Complications of Airway Management]]
:[[Intraoperative Atelectasis]]
:[[Laryngospasm]]
:[[Nebulization]]
:[[Extubation]]
:[[Deep Extubation]]

==Vascular Access==
:[[Intravenous catheter placement & Care]]
:[[Central Venous Catheter placement & Care]]
:[[Intraosseous Access & Care]]
:[[Arterial catheter placement & Care]]
:[[Intranasal Drug Delivery]]
:[[Needlestick Injury]]

==Regional Blockade==
:[[Principles of Regional Anesthesia in Children]]
:[[The use of Ultrasound for Regional Anesthesia]]
:[[Local Anesthetics in Children]]
::[[Topical Analgesics]]
:[[Local Anesthetic Adjuncts in Children]]
:[[Continuous Catheter Infusion (Outside of Hospital)]]
:[[Local Anesthetic Systemic Toxicity - LAST]]
:[[Nerve Complications of Regional Blockade]]
:[[Peripheral Nerve Stimulation]]
:[[Compartment Syndrome and Regional Blockade]]
:[[Post-Dural Puncture Headache]]
:[[Rebound Pain after Nerve Block]]
:[[Vasodilatory Effect of Blockade]]

Blocks:
:[[Axial Blockade]] ([[Caudal]], [[Lumbar Epidural]], [[Thoracic Epidural]], [[Spinal]], [[Combined Spinal/Caudal]])

:[[Head & Neck]] ([[Palatal]], [[Buccal]], [[Supraorbital & Trochlear Nerve Blocks]], [[Oral Nerve Blocks]], [[Superficial Cervical Plexus Block]], [[Suprazygomatic Maxillary Nerve]], [[Infraorbital Nerve Block]], [[Scalp Blocks]], [[Ophthalmic Blocks]])

:[[Upper Extremity]] ([[Interscalene]], [[Supraclavicular]], [[Infraclavicular]], [[Axillary]], [[Peripheral Arm]], [[Intravenous Regional (Bier)]])

:[[Thorax]] ([[Intercostal]], [[Paravertebral]], [[Erector Spinae Plane]], [[Pleural]], [[Pectoral]], [[Serratus Anterior]])

:[[Abdomen]] ([[Rectus Sheath]], [[Transversus Abdominus Plane]], [[Quadratus Lumborum]], [[Ileoinguinal/Ileohypogastric]], [[Pudendal]], [[Penile]])

:[[Lower Extremity]] ([[Lumbar Plexus]], [[PENG]], [[Femoral]], [[Adductor Canal]], [[4 in 1]], [[Sciatic]], [[Popliteal]], [[iPACK]], [[Ankle]])

==Blood Conservation Techniques==
:[[Cell Saver]]
:[[Controlled Hypotension]]
:[[Tranexamic Acid]]
:[[Reducing Blood Draw Anemia]]

==Cardiopulmonary Resuscitation==
:[[Intraoperative Cardiac Arrest]]
:[[Pediatric CPR]]
:[[Code Teams]]
:[[PALS Protocols]]
:[[Prone CPR]]
:[[ECMO]]
:[[CPR Coach]]
:[[Crisis Management]]
:[[Parental Presence During Resuscitation / CPR]]
:[[Breaking Bad News]]

=Syndromes/Disorders=
[https://sites.uclouvain.be/anesthweekly/MRP_ENG/index.html Syndromes & Rare Diseases in Pediatrics: Anesthesia]

[https://rarediseases.info.nih.gov/diseases/browse-by-first-letter Genetic and Rare Diseases Information Center]

[https://www.ncbi.nlm.nih.gov/books/NBK430685/ StatPearls (National Library of Medicine)]

[https://www.orphananesthesia.eu/en/home-2.html OrphanAnesthesia]

:[[Achalasia]]
:[[Achondroplasia]]
:[[Acute Flaccid Myelitis]]
:[[Adrenal Insufficiency]]
:[[Alagille Syndrome]]
:[[Alpha-Gal Syndrome]]
:[[Anaphylaxis]]
:[[Anencephaly/Hydranencephaly]]
:[[Angelman Syndrome]]
:[[anti-NMDA receptor encephalitis]]
:[[Apert Syndrome]]
:[[Arthrogryposis]]
:[[Asthma]]
:[[Autism Spectrum]]
:[[Beckwith-Wiedemann syndrome]]
:[[Bronchopulmonary Dysplasia]]
:[[Brugada Syndrome]]
:[[Cardiac Tamponade]]
:[[Cardiomyopathy]]
:[[Cerebral Palsy]]
:[[CHARGE association]]
:[[Charcot-Marie-Tooth Disease]]
:[[Cleft lip and/or palate]]
:[[Cleidocranial dysplasia]]
:[[Cocaine Use]]
:[[Conjoined Twins]]
:[[Cornelia de Lange Syndrome]]
:[[COVID]]
:[[Craniosynostosis]]
:[[Croup]]
:[[Cystic Fibrosis]]
:[[DiGeorge syndrome (22q11.2 deletion syndrome)]]
:[[Diabetes]]
:[[Disseminated Intravascular Coagulation]]
:[[Down Syndrome]]
:[[Duchenne muscular dystrophy]]
:[[Early (J Point) Repolarization]]
:[[Ehlers-Danlos Syndrome]]
:[[Epidermolysis Bullosa]]
:[[Factor V Leiden]]
:[[Fanconi Anemia]]
:[[Fetal and Neonatal Arrhythmias]]
:[[Freeman-Sheldon Syndrome]]
:[[Genetic Disease]]
:[[G6PD]]
:[[Goldenhar syndrome]]
:[[Guillain–Barré syndrome]]
:[[Hereditary Angioedema]]
:[[Hereditary Spherocytosis]]
:[[Heterotaxy Syndrome]]
:[[Hiccups]]
:[[Inherited metabolic disorders]]
:[[Intrauterine Drug Exposure]]
:[[Joubert Syndrome]]
:[[Kartagener's syndrome]]
:[[Ketogenic Diet]]
:[[Klippel-Feil syndrome]]
:[[Klippel-Trenaunay syndrome]]
:[[Leigh’s Syndrome]]
:[[Lennox-Gastaut syndrome]]
:[[Long QT Syndrome]]
:[[Malignant Hyperthermia]]
:[[Maple Syrup Urine Disease]]
:[[Marijuana Use]]
:[[Mastocytosis]]
:[[Measles]]
:[[Medical Child Abuse]]
:[[Medium-chain acyl-CoA Dehydrogenase Deficiency]]
:[[Menkes Disease]]
:[[Mesenteric Traction Syndrome]]
:[[Minimal Change Disease]]
:[[Mitochondrial Disease]]
:[[Möbius syndrome]]
:[[Monkeypox]]
:[[Moya Moya Syndrome]]
:[[Mucopolysaccharidoses]]
:[[Myasthenia Gravis]]
:[[Myotonic dystrophies]]
:[[Nephrotic Syndrome]]
:[[Neuroleptic Malignant Syndrome]]
:[[Niemann-Pick Disease]]
:[[Nonaccidental Trauma]]
:[[Noonan syndrome]]
:[[Obesity]]
:[[Obstructive Sleep Apnea]]
:[[Ophthalmologic Disease]]
:[[Osteogenesis imperfecta]]
:[[Pacemakers]]
:[[Papillomatosis]]
:[[Patent Ductus Arteriosus]]
:[[Periodic Fever Syndromes]]
:[[Pheochromocytoma]]
:[[Pierre Robin sequence]]
:[[Polycythemia Vera]]
:[[Porphyria]]
:[[Postural orthostatic tachycardia syndrome (POTS)]]
:[[Prader-Willi Syndrome]]
:[[Priapism]]
:[[Pseudocholinesterase Deficiency]]
:[[Pulmonary Hypertension]]
:[[Red-Head (MC1R) variant]]
:[[Renal Agenesis]]
:[[Retinopathy of Prematurity]]
:[[Rett Syndrome]]
:[[Rubinstein-Taybi Syndrome]]
:[[Sepsis]]
:[[Serotonin Syndrome]]
:[[Sickle Cell Disease]]
:[[Smoking and Vaping]]
:[[Special Needs]]
:[[Spina Bifida]]
:[[Spinal Cord Injury]]
:[[Spinal Muscular Atrophy]]
:[[Stevens-Johnson Syndrome]]
:[[Stickler Syndrome]]
:[[Stroke]]
:[[Sturge Weber]]
:[[Substance Use Disorder]]
:[[Tetanus]]
:[[Thyrotoxicosis]]
:[[Treacher Collins syndrome]]
:[[Trochlear Palsey]]
:[[Tuberous Sclerosis]]
:[[Tumor Lysis Syndrome]]
:[[Turner syndrome]]
:[[VACTERR (or VACTERL) association]]
:[[Vein of Galen Malformation]]
:[[Venous Thromboembolism]]
:[[Von Hippel-Lindau Syndrome]]
:[[Von Willibrand’s Disease]]
:[[Waardenburg syndrome]]
:[[Williams Syndrome]]
:[[Wolff-Parkinson-White syndrome]]

=Procedure Based Discussions=
:[[Generalized Suggested Outline]]

==General Surgery==
:[[Appendectomy]]
:[[Bariatric]]
:[[Bronchoscopy]]
:[[Burns]]
:[[Button Battery Ingestion]]
:[[Central Line Placement (Hickman/Broviac/Infusaport)]]
:[[Chest Tube - Thoracentesis]]
:[[Cholelithiasis]]
:[[Cystic Adenomatous Malformation (CAM)]]
:[[Diaphragmatic Hernia]]
:[[Duodenal Atresia]]
:[[Gastrochisis]]
:[[Inguinal Hernia]]
:[[Kasai Procedure]]
:[[Laparoscopy]]
:[[Magnet Ingestion]]
:[[Malrotation]]
:[[Necrotizing Enterocolitis]]
:[[Neuroblastoma]]
:[[Omphalocoele]]
:[[Ovarian Torsion]]
:[[Pectus Excavatum/Carinatum]]
:[[Pheochromocytoma]]
:[[Pyloric Stenosis]]
:[[Sacrococcygeal Teratoma]]
:[[Thoracotomy]]
:[[Thymectomy]]
:[[Thyroid/Parathyroid]]
:[[Tracheo-Esophageal Fistula]]
:[[Tracheopexy]]
:[[Trauma]]
:[[Umbilical Hernia]]
:[[Umbilical Herniorrphy]]

==Transplant==
:[[Liver Transplant]]
:[[Renal Transplant]]
:[[Cardiac Transplant]]
:[[Organ Procurement]]

==Otolarngology/Head & Neck Surgery(ENT)==
:[[Auditory Evoked Potentials]]
:[[Bleeding Upper Airway]]
:[[Bone Anchored Hearing Aid (BAHA)]]
:[[Bronchoscopy]]
:[[Cricoid Split Procedure]]
:[[Drug-induced sleep endoscopy (DISE)]]
:[[Epiglottitis]]
:[[EXIT Procedure]]
:[[Foreign Body in Airway]]
:[[Glottic Web]]
:[[Hypoglossal Nerve Stimulators]]
:[[Laryngotracheal Reconstruction]]
:[[Mastoidectomy]]
:[[Myringotomy Tubes]]
:[[Papillomatosis]]
:[[Retropharyngeal Abscess]]
:[[Suspension Micro Laryngoscopy]]
:[[Thyroglossal Duct Cyst]]
:[[Tonsillectomy/Adenoidectomy]]
:[[Tracheostomy]]
:[[Vallecular Cyst]]

==Fetal==
:[[Fetal Interventions]]
:[[ex utero intrapartum treatment (EXIT)]]

==Dental/Oral Surgery==
:[[Dental Restoration]]
:[[Dental Extraction]]
:[[Dental Sedation]]

==Orthopedics==
:[[Idiopathic Scoliosis]]
:[[Neuromuscular Scoliosis]]
:[[Slipped Capital Femoral Epiphysis]]
:[[Upper Extremity Fracture]]
:[[Lower Extremity Fracture]]
:[[Bone Cement]]
:[[Compartment Syndrome]]
:[[Tourniquet Use]]
:[[Clubfoot Repair]]
:[[Total Knee Arthroplasty]]
:[[Anterior Cruciate Ligament Repair]]
:[[Pelvic Arthroplasty/Osteotomy]]

==Neurosurgery==
:[[General Neurosurgery]]
:[[Brain Tumor Craniotomy]]
:[[Arnold Chiari Malformation]]
:[[Ventriculo-Peritoneal Shunt]]
:[[Spinal Cord Untethering]]
:[[Encephalocele]]
:[[Spinal Cord Injury]]
:[[Awake Craniotomy]]
:[[Vagal Nerve Stimulator]]
:[[Arteriovenous Malformation]]
:[[Traumatic Brain Injury]]
:[[Air Embolism]]
:[[Spina Bifida - Myelomeningocele]]
:[[Pituitary Surgery]]
:[[Craniosynostosis]]
:[[Tethered Cord]]
:[[Rhizotomy]]

==Plastics==
:[[Craniosynostosis]]
:[[Craniofacial Reconstruction]]
:[[Cleft lip and/or palate]]
:[[LeFort Advancement]]
:[[Pierre Robin Mandibular Distraction]]
:[[Septo-Rhinoplasty]]
:[[Dermatologic Laser Therapy]]

==Urology==
:[[Circumcision]]
:[[Inguinal Hernia]]
:[[Cystoscopy]]
:[[Hypospadias]]
:[[Ureteral Re-Implantation]]
:[[Bladder Augmentation]]
:[[Neonatal Exstrophy]]
:[[Testicular Torsion]]
:[[Orchiopexy]]
:[[Robotic Surgery]]

==Transgender Topics==
:[[Transgender Terminology]]
:[[Assessment of the Transgender Patient]]
:[[Gender Confirming Therapies]]
::[[Hormone Therapy]]
::[[Feminizing Procedures]]
::[[Masculinizing procedures]]
::[[Perioperative Care]]

==Ophthalmology==
:[[Strabismus]]
:[[Glacoma]]
:[[Retina]]
:[[Retinoblastoma]]
:[[Nasolacrimal Duct]]
:[[Ptosis]]
:[[Open Globe]]
:[[Orbital Trauma/Fracture]]

==Cardiac/Congenital Heart Disease==
:[[Basic Cardiac Principles]]
:[[Transitional Circulation]]
:[[Cyanotic Lesions]]
:[[Non-cyanotic Lesions]]
:[[Cardiopulmonary Bypass]]
:[[Cardiac Catheterization]]
:[[Non-Cardiac Procedures]]

==Gastroenterology==
:[[Upper Endoscopy]]
:[[Lower Endoscopy/Colonoscopy]]
:[[Endoscopic Retrograde Cholangio-Pancreaticogram]]
:[[Liver Biopsy]]

==Oncology==
:[[Perioperative Care of the Child with Cancer]]
:[[Lumbar Puncture]]
:[[Bone Marrow Aspirate/Biopsy]]
:[[Bone Marrow Harvest]]
:[[Anterior Mediastinal Mass]]
:[[Wilms’ Tumor]]
:[[Radiation Therapy]]

==Robotic Surgery==
:[[Principles/Physiology]]
:[[Urology]]
:[[Orthopedics]]
:[[General Surgery]]

==Maternal-Fetal==
:[[Introduction to Fetal Anesthesia]]
:[[Pre-Partum Procedures]]
:[[Ex utero intrapartum treatment (EXIT)]]

==Radiology==
:[[Interventional Radiology]]
::[[Gastic-Jejunal Feeding Tube Insertion]]
::[[Vascular/Lymphatic Malformation]]
::[[Whitaker Procedure]]
::[[Percutaneous Nephrostomy]]
::[[Endovascular Liver Biopsy]]
::[[Cyst Drainage]]

:[[Magnetic Resonance Imaging]]
::[[Head/Body]]
::[[Cardiac MRI]]
:[[Positron Emission Tomography (PET)]]

:[[Neuroradiology]]
::[[Wada Test]]
::[[Vein of Galen Malformation]]
::[[Ophthalmic Artery Injection]]

:[[Urodynamic Studies]]
:[[Varicocele]]

==Psychiatry==
:[[Electroconvulsive Therapy]]

==Pain Management==
:WFSA: [[Perioperative analgesic pharmacology in children]]
:[[Overview of Pain in Children]]
:[[Factors that Modulate Pediatric Pain]]
:[[Assessment of Pain in Children]]
:[[Multimodal Pain Management in Children]]
:[[Pain Treatment in Children]]
::[[Acute Pain]]
:::[[Surgical]]
:::[[Medical]]
::[[Chronic Pain]]
:::[[Acute Pain that Becomes Chronic]]
:::[[Surgical]]
:::[[Medical]]
:[[Patient/Nurse/Parent Controlled Analgesia]]
:[[Patient Controlled Epidural Anesthesia]]
:[[Cancer Pain]]
:[[Hypnosis]]
:[[Honey]]
:[[Pain Management in the Intensive Care Unit]]
:[[Cryoanalgesia]]

==Palliative Care==
:[[Principles of Pediatric Palliative Care]]
:[[Transitioning to Palliative Care]]
:[[Setting Goals]]
:[[Techniques in the Palliative Setting]]
:[[End of Life Care]]
:[[Futile Care]]

=Operational/Procedural Topics=

==Care of the Pediatric Anesthesiologist==
:[[Ergonomics and Physical Factors]]
:[[Psychologic Stress]]
:[[Imposter Syndrome]]
:[[Diversity, Equity, and Inclusion]]
:[[Clinical Decision-Making]]
:[[Performance and Compensation]]
:[[The Aging Anesthesiologist]]
:[[Academic Matters]]

==Operating Suite Design and Implementation==
:[[Medical Language Interpretation]]
:[[Pre-operative Evaluation Center]]
:[[Pre-operative In-Take]]
:[[Operating Room Design]]
:[[Post-anesthesia Care Unit]]
:[[Remote Anesthesia Locations]]
::[[Radiology]]
::[[Magnetic Resonance Suite]]
::[[Cardiac Catheterization]]
::[[Pet Scanner]]
::[[CT Scanner]]
::[[Emergency Department]]
::[[Office-based Practice]]
:[[Scheduling Strategies]]
:[[Environmental and Occupational Considerations]]
:[[Intraoperative Communication]]
:[[Personal Electronic Devices]]

==Sedation of the Pediatric Patient==
:[[Transporting the anesthetized Pediatric Patient]]
:[[Dental Sedation]]
:[[Creating a Sedation Service]]

==Recovery of the Pediatric Patient==
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post-Operative Nursing Care]]
:[[Emergence Delirium]]
:[[Delayed Emergence]]
:[[Post-Operative Behavior Changes]]

==Personnel Safety in the Pediatric Environment==
:[[Operating Room Fires]]
:[[Active Shooter]]
:[[Magnetic Resonance Imaging - MRI]]
:[[X-Ray & Radiologic Safety]]

==Special Topics in Mass Casualty Incidents==

:[[Principles of MCI and Pediatrics]]
:[[MCI Action List]]
:[[MCI app/Goals]]

==Transport of the Critically Ill Child==

:[[Ground Transport of Critically Ill Child]]
:[[Helicopter Emergency Medical Services- HEMS]]

==Low Resource Environments==
:[[Low Resource Environment Issues]]
:[[In-Flight Emergencies]]

==The Pediatric Perioperative Surgical Home==
:[[Enhanced Recovery After Surgery - ERAS]]
:
----

=Editing tools=
:[[TYK_Question_List]]
:[[Working Sandbox]]

MCI Action List

2026-09-30T01:37:29Z

WikiSysop: /* STAGE 6 (RESOLUTION) GOALS */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::Keep in
::Call in
::Standby
::Reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

=== Release excess staff home ===

=== Resume elective procedures again ===

=== Refresh new staff ===

=== De-escalate security ===

=== Restock supplies ===

=== Laundry/Room Flips ===

MCI Action List

2026-09-30T01:30:59Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::Keep in
::Call in
::Standby
::Reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

MCI Action List

2026-09-30T01:28:26Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|5-3333
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

MCI Action List

2026-09-30T01:26:10Z

WikiSysop: /* Needs Assessment */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===

* Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport

* Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious

* Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

* Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department 
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

MCI Action List

2026-09-30T01:24:05Z

WikiSysop: /* Activate Preparation Response (local) */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===
->Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport
->Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious
->Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department 
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

'''Declare/verify''' appropriate Patient Influx Plan (ED/Hospital)

'''Activate''' local incident command (administration)

'''Notify''' clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

'''Mobilization''' [partial] of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local '''reverse triage'''

'''Decide/Assess:'''
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

MCI Action List

2026-09-30T01:20:55Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===
->Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport
->Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious
->Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
|5-2280
|
|Facilities
|
|-
|Peds Emergency Department 
|5-5681
|
|
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

Declare/verify appropriate Patient Influx Plan (ED/Hospital)

Activate local incident command (administration)

Notify clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

Partial mobilization of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local reverse triage

Decide/Assess:
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

Renal Transplant

2026-09-30T00:19:43Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/34379843/ Perioperative anesthesia care for the pediatric patient undergoing a kidney transplantation: An educational review]

[https://pubmed.ncbi.nlm.nih.gov/11094698/ Anesthesia for kidney transplant surgery]

[https://pubmed.ncbi.nlm.nih.gov/28784219/ Anesthesia for Kidney and Pancreas Transplantation]

[https://pubmed.ncbi.nlm.nih.gov/34013706/ Evaluation of the learning curve of pediatric kidney transplantation anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/35725045/ Anesthetic considerations for pediatric abdominal solid organ transplantation]

[https://pubmed.ncbi.nlm.nih.gov/37343576/ Balanced crystalloid solution versus saline in deceased donor kidney transplantation (BEST-Fluids): a pragmatic, double-blind, randomised, controlled trial]

Hayes WN, Laing E, Brown R, Silsby L, Smith L, Thomas H, Kaloyirou F, Sharma R, Griffiths J, Hume-Smith H, Marks SD, Kessaris N, Christian M, Dudley J, Shenoy M, Malina M, Muorah M, Ware N, Yadav P, Reynolds B, Bryant W, Spiridou A, Wray J, Peters MJ: A pragmatic, open-label, randomized controlled trial of Plasma-Lyte-148 versus standard intravenous fluids in children receiving kidney transplants (PLUTO). Kidney Int 2024; 105: 364-375

Williamson SJ, Plant ND, Shenoy M: Use of normal saline and incidence of dyselectrolytaemia in children following kidney transplantation. Pediatr Nephrol 2022; 37: 2127-2130

Hayes W, Longley C, Scanlon N, Bryant W, Stojanovic J, Kessaris N, Van't Hoff W, Bockenhauer D, Marks SD: Plasma electrolyte imbalance in pediatric kidney transplant recipients. Pediatr Transplant 2019; 23: e13411

Wyatt N, Norman K, Ryan K, Shenoy M, Malina M, Weerassoriya L, Merritt J, Balasubramanian R, Hayes W: Perioperative fluid management and associated complications in children receiving kidney transplants in the UK. Pediatr Nephrol 2023; 38: 1299-1307

Hayes W, Laing E, Foley C, Pankhurst L, Thomas H, Hume-Smith H, Marks S, Kessaris N, Bryant WA, Spiridou A, Wray J, Peters MJ: Multicentre randomised controlled trial: protocol for Plasma-Lyte Usage and Assessment of Kidney Transplant Outcomes in Children (PLUTO). BMJ Open 2022; 12: e055595

[https://www.ectrx.org/forms/ectrxcontentshow.php?year=2025&volume=23&issue=1&supplement=0&makale_no=0&spage_number=72&content_type=FULL%20TEXT Ultrasonogram-Guided Continuous Quadratus Lumborum Block as Pain Management in Pediatric Kidney Transplant Recipients: A Case Series]

[https://resources.wfsahq.org/atotw/anaesthesia-for-paediatric-renal-transplant/ WFSA: Anaesthesia for Paediatric Renal Transplant]

Ooi K, Dobby N, Marks S. et al. [https://www.bjaed.org/article/S2058-5349(26)00053-3/abstract Perioperative management of kidney transplantation in children] BJA Education, 2026; 26, 393-400

MCI Action List

2026-09-29T22:27:46Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===
->Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport
->Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious
->Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Adult Emergency Department
Peds Emergency Department 
|5-2280 5-5681
|
|Facilities
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

Declare/verify appropriate Patient Influx Plan (ED/Hospital)

Activate local incident command (administration)

Notify clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

Partial mobilization of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local reverse triage

Decide/Assess:
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips

MCI Action List

2026-09-29T22:20:03Z

WikiSysop: /* Incident situation */

==STAGE 1 (INITIATE) GOALS==

=== Needs Assessment ===
->Estimated time-line
:Now/10min/60min/hours
:Walk-in/Ground Ambulance/Air Transport
->Injury types (COBRA/CBRNE)
:Trauma/Burn/Chemical/Radiation/Infectious
->Incoming patients
:Children/Adults/Numbers

=== Incident situation ===
ED/OR/Hosp capacity assessment

Census, Open Beds, Expandable Space

Asset Assignment
{| class="wikitable"
|+
!Location
!Phone
!
!Location
!Phone
|-
|Hospital Incident Command
|
|
|ACCM Incident Command
|
|-
|
|
|
|Peds Shift Coordinator
|
|-
|ZBOR4 Anes Commander
|7-2777
|
|Adult Anes Commander
|
|-
|ZBOR4 Surg Commander
|
|
|
|
|-
|ZBOR4 Nursing Commander
|
|
|
|
|-
|ZBOR4 Pre-Op
|2-5890
|
|Radiology
|
|-
|ZBOR OR Desk
|5-6520
|
|Blood Bank
|
|-
|ZBOR4 PACU
|5-5722
|
|Security
|
|-
|ZBOR4 PICU
|5-5260
|
|EVS
|
|-
|Emergency Department
|5-2280
|
|Facilities
|
|}

==== Staff - communicate/assign ====
:Pre-OP - Triage Staging/OR Holding
:OR - Immediate Surgical/Damage Control
:Post-OP - PACU/Minor Procedure/PICU Annex
:Consider call-in tree activation
::call in
::standby
::reserve staff (12 hour hold)

==== Space - assign/secure ====
:Consider double stretcher in rooms
:PrepPACU/OR Corridor: stretchers/beds/equipment

==== Stuff - secure/prepare/deliver ====
:Stretchers/Monitors
:Fluids/Blankets/Triage Intervention
:Personal Protective Equipement

=== Activate Preparation Response (local) ===
(understand basic concepts of Patient Influx Protocols)
:[https://hpo-docs.jh.edu/I8EMHRyj EP318 Patient Influx: Mass Casualty - ED]
:[https://hpo-docs.jh.edu/KxeyOf0y EP317 Patient Influx: Mass Casualty Physician Teams]
:[https://hpo-docs.jh.edu/ZuKVoCVH EP322 Patient Influx: Mass Casualty Bio]
:[https://hpo-docs.jh.edu/1O8qyPQX EP323 Patient Influx: Mass Casualty Chemical]
:[https://hpo-docs.jh.edu/4uVAB1aA EP324 Patient Influx: Mass Casualty Radiation]
:[https://hpo-docs.jh.edu/WlMMKGUN EP333 Patient Influx: Epidemic/Pandemic Respiratory Illness (EPRI) Response Plan]

Declare/verify appropriate Patient Influx Plan (ED/Hospital)

Activate local incident command (administration)

Notify clinical departments: ED, trauma for Peds & Adults, radiology & shift coordinators

Partial mobilization of staff: ED trauma nurses, radiology, public affairs, EVS, security

Activate local reverse triage

Decide/Assess:
:Define staff, space, stuff needs
:Acquire/Prepare additional supplies
:[partial] mobilization of hospital incident command

==STAGE 2 (RAMP UP) GOALS==

=== Needs Assessment ===
:Situation
::incoming patients
::needs assessment
::estimated ongoing time-line
:Hospital/Local capacity needs assessment

=== Activate Hospital Response ===
:(understand base concepts of code yellow ED vs. code yellow Hospital)
:⁃Declare code yellow HOSPITAL
:⁃Activate Hospital incident command (HICS)
:⁃Notify clinical departments: wards, trauma for Peds & Adults, radiology & shift coordinators
:⁃Stop elective operations (ORs/Clinics)
:⁃Mobilization of staff: Hospital nursing, blood bank, EVS, radiology, public affairs, security, public affairs, facilities
::⁃Call in additional staff
::-Activate hospital-wide reverse triage

=== Decide/Assess: ===
:⁃[partial] mobilization of hospital incident command
:⁃Define staff, space, stuff needs
:⁃Acquire/Prepare additional supplies
:⁃Establish contact with other hospitals
:⁃Go on ED diversion
:⁃Contact materials management for more supplies (eg, PPE)

=== Activate concepts of Re-Triage ===

==STAGE 3 (ACTIVE) GOALS==

=== Triage + Treat Patients ===
:Immediate interventions
::Airway (oxygen)
::Bleeding (tourniquet)
::Chest tube
::Antidote

=== Move Patients Around ===
:- match resources to needs

=== Expand available space to accommodate more patients ===
:- repurpose space as necessary

=== Secure perimeter/crowd control ===
:-“Protect the House”

=== Attempt to Resupply ===
:- Anticipate ongoing needs
:- Consider time-limited resources

==STAGE 4 (CONSOLIDATION) GOALS==

=== Recursive needs assessment: open ICU/OR beds ===

=== Maintain contact with other hospitals ===
:-borrow supplies
:-re-supply

=== Media/crowd management ===

=== Re-Triage ===

==STAGE 5 (ON-GOING MANAGEMENT) GOALS==

=== Staff management ===

* fatigue mitigation
* food
* sleeping quarters

=== Family management ===

=== Advanced triage ===

=== Definitive Treatment ===

** ICU, OR, Home, Psych Liaison, Morgue

=== Ongoing security ===

==STAGE 6 (RESOLUTION) GOALS==

Send excess staff home

Begin elective procedures again

Bring in new staff

De-escalate security

Restock supplies

Laundry/Room Flips