Preoperative paediatric considerations
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.
Build Knowledge✅
Improve Safety ✅
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