• Things that Keep Us Up at Night: Unexpected OR Emergencies in Healthy Children in the Ambulatory Setting (607-SPA)
• 1:10-3:10 p.m. Monday
• BCEC Room 252AB

A growing number of surgical procedures are performed on healthy children in ambulatory surgery centers and satellite hospitals where emergencies are rare. Emergencies do happen, so anesthesiologists need to be prepared.

The latest treatments for three life-threatening conditions and tips to set up an emergency response training program with high-fidelity simulation will be explored in an education session Monday.

Constance Houck, M.D., M.P.H.

“These are all things that could happen. You should prepare for them by making sure you have appropriate treatment algorithms and the proper medications and equipment,” said session moderator Constance Houck, M.D., M.P.H. “These are emergencies where you might be less prepared because these are healthy children having routine types of operations.”

The three conditions that will be explored are anaphylaxis, massive unexpected hemorrhage and malignant hyperthermia. A fourth presentation will explain the use of emergency checklists and simulation to improve processes, said Dr. Houck, an Associate Professor in Anaesthesia at Harvard Medical School and a Senior Associate in Perioperative Anaesthesia at Boston Children’s Hospital.

“Two of these three events happened in our satellite hospital where we not only had to deal with them quickly but also needed to arrange timely transfer to the main hospital,” she said. “For this session, we also chose to discuss malignant hyperthermia because there are some new approaches that can make emergency treatment much easier.”

The greatest challenges during an emergency in these facilities are the limited number of personnel and the lack of emergency equipment compared to major hospitals. It is important to have basic emergency equipment and supplies ready and easily accessible, including blood and emergency medications, Dr. Houck said.

“We want to make sure people are prepared for dealing with the types of things we occasionally see — the devastating things that can happen to otherwise healthy children unexpectedly,” she said.