Anaes SAQs · Paediatric anaesthesia
Sick child: sepsis and congenital heart disease
Final-examination SAQ for sick-child-sepsis-congenital-heart.
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ANZCAFRCAEDAICABAFCAI
Prompt
A 2-year-old with purpuric rash, tachycardia, CRT 5 s and suspected intra-abdominal source needs emergency laparotomy. Separately outline principles for anaesthetising a neonate with duct-dependent systemic blood flow on prostaglandin. Cover resuscitation, induction, monitoring, and crisis priorities.
Model answer
Sepsis (8). ABC; IV/IO; early antibiotics; fluid aliquots with reassessment; early vasoactives if fluid-refractory; source control; ketamine-preferential induction with vasopressors ready; arterial line; ICU.[1][2]
Duct-dependent neonate (7). Continue PGE; balance Qp:Qs; careful FiO2; maintain coronary/systemic perfusion; de-air lines; senior cardiac help; avoid pure high-dose volatile collapse.[3]
References3ShowHide
- [1]Weiss SL et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med, 2020.PMID 32032273
- [2]Weiss SL et al. Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026. Pediatr Crit Care Med, 2026.PMID 41869844
- [3]Khalil M, Jux C, Rueblinger L, et al. Acute therapy of newborns with critical congenital heart disease. Transl Pediatr, 2019.PMID 31161078