Preoperative paediatric considerations

paediatric preoperative care Jul 14, 2025

The Little Things That Count – Preoperative Paediatric Considerations 🧸

Paediatric patients are not just small adults — they come with unique anatomical, physiological, developmental, and emotional considerations. Preoperative preparation must be holistic, taking into account both the child and their family.

🔹 Developmental Stages & Communication
Children's understanding varies significantly by age:

  • Younger children may experience separation anxiety and fear of strangers.
  • Older children may have concerns about body image, self-esteem, or fears like waking during surgery.
    ➡️ Perioperative nurses should assess the child's developmental level and tailor communication strategies accordingly.

🔹 Airway Assessment 💨
Children’s airways are anatomically different and more reactive:

  • Consider large tongue size, high laryngeal position, and loose teeth.
  • Be alert to recent or ongoing URTIs, which may increase anaesthetic risk.
    ➡️ A thorough airway assessment is crucial before proceeding with surgery.

🔹 Hydration & Fasting 💧
Kids are more vulnerable to both dehydration and fluid overload:

  • Maintain close monitoring of hydration status.
  • Follow a “sip till send” approach where appropriate, allowing clear fluids until close to surgery time.

🔹 Family Involvement & Emotional Support ❤️
Family dynamics play a major role in a child’s perioperative experience:

  • Anxiety is often high among caregivers.
  • Involve families early in planning and discussions to reduce stress and build trust.

🔹 Special Needs Considerations
Children with disabilities or behavioural challenges may need:

  • Tailored perioperative plans
  • Premedication to reduce distress
    ➡️ Early identification and communication across teams help ensure a smoother journey.

By focusing on the little things, perioperative nurses can make a big difference in the surgical experience of paediatric patients and their families.

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