Pediatric surgery is a specialty that takes care of children from birth to late adolescence. And you don’t have to be working at a children’s specialty hospital or a big academic facility to take care of a child having surgery, either. Pediatric surgeries are performed all over the country in surgery centers and many hospitals, along with those large pediatric and academic facilities, so we all need to be prepared to take care of these special patients. We could never create an all-inclusive list in a single blog post, but today we've got a great Top 10 list to get you started!
1. Keep the room warm!
Temperature regulation is important in the pediatric group, especially in neonates. They are prone to greater heat loss than adults having surgery due to their larger surface area per kilogram of body weight, having thinner skin and lower body fat content. We know warm patients have better surgical outcomes, so a warm room is essential.
2. Children aren't just “little adults”.
Children’s care varies greatly from adult care. Their emotional and mental states are different than an adult, so we need to treat kids like they’re kids. The cases also require different instruments than the same adult surgery might. The medications may be different, too. The dosing most certainly will be. Peds and adult surgeries are very different so we have to take everything into consideration and treat them for what they are - kids!
3. Parents are patients, too!
Pediatrics is a patient and family-centered care approach. Sure, the parents must consent to tests and treatments of their children since they are minors, but the parents need to be considered as well. It’s nerve wracking as a parent to watch your child go through the angst and pain of a surgical procedure. And parents are just as nervous and scared as their child is. Nurses must give the same compassionate care to the parents as to the child.
4. Medications are weight based.
We all remember learning the mgs/kgs math in nursing school in our peds course. An accurate weight must be known to the OR team at all times so the proper doses of medications are given. There are many resources available to make sure that you're always giving the correct dose.
5. Child Life Specialists are your friends.
Child Life Specialists are health care professionals who help children and their families during hospitalizations, illness, and injuries. They help support families and help the child cope with what’s going on in their life at the moment. They are a great resource to help prepare a child for surgery and make it a less traumatic event.
6. Be aware of Malignant Hyperthermia (MH).
MH is a genetic disorder and patients may not know they’re at risk for this condition until they have surgery. Parents may know they have a risk of passing it to their children, but unless they are tested, they may not know if the children are carriers. OR teams must know what to do if an MH crisis occurs and be ready to handle the situation quickly.
7. Padding is important when positioning.
Pad everything! Children have thinner, more sensitive skin and it is easy to get marks on their skin. Marks and indentations can lead to further skin breakdown, and we want to protect their skin, nerves, bones, and tissues as much as we can.
8. Pediatric surgery could mean taking care of the patient before it’s even born!
Fetal surgery falls under pediatric surgery. Fetal surgery is the specialty of operating on a fetus while still in the womb of the mother. This delicate surgery requires caring for two patients at once.
9. Communication and trust are crucial!
Parents are scared to put their child into the hands of someone else, even healthcare providers. A qualified, compassionate, patient surgical nurse can make a world of difference in a child’s and their family’s experience with surgery.
10. There are Pediatric-specific credentials.
Pediatric Advance Life support (PALS), Neonatal resuscitation (NRP), and STABLE which is a 6 step assessment in the treatment of post-resuscitation/pre-transportation of sick infants. These extra certifications can ensure nurses are up-to-date on the most evidence-based care of kids!
While certainly not all-inclusive, this Top 10 list is a great place to start! You can also read this Facebook post where many pediatric experts chimed in with info that they believe is a MUST to know - so check it out!