TYK314

The preoperative evaluation of a child with type I diabetes mellitus should include all of the following EXCEPT:

a) Assessment at least 1 day prior to elective anesthesia to allow time to institute changes in therapy if needed

b) Confirmation of the child’s insulin management regimen including insulin dose and blood glucose goals with the family and primary care doctor or endocrinologist

c) Scheduling as the first case of the day to minimize NPO time

d) Administration of the patient’s usual dose of long-acting insulin the night prior to surgery

e) Discussion of whether the patient’s insulin pump should be continued during the case

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Answer

Answer a. All of the above are prudent for preoperative care of the child with Type I diabetes, except that diabetics should be assessed at least 10 days (not 1 day) prior to elective anesthesia. Serum electrolytes are also an important part of the evaluations, and hemoglobin A1C assessment may provide information as to the child’s general state of diabetes control. Hemoglobin A1C assessment reflects chronic control (not any acute changes made prior to anesthesia) and is not a universally-required part of the evaluation process at all centers.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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