Search

Children and adolescents with disabilities have the right of full and effective participation and inclusion in society. Disability includes a wide range of long-term physical, mental, intellectual and sensory impairments for various reasons. In addition to the basic illness many children with disabilities have concomitant diseases. These diseases are decisive for the perioperative risk. Information from parents regarding their child's behavioural patterns and needs, signs of escalating anxiety and pain are important. Perioperative dialog with the parents is helpful and has positive effects also from parental point of view. Pharmacologic premedication is recommended. Induction of anaesthesia can be challenging and sometimes requires unconventional methods. Pain behaviour may be unusual. There are suitable scales that incorporate such behaviours.Die sichere anästhesiologische Versorgung von Kindern und Jugendlichen mit körperlichen oder geistigen Behinderungen ist zumeist zeitaufwendig und anspruchsvoll. In diesem Beitrag wollen wir auf Besonderheiten in der perioperativen Versorgung von behinderten Kindern und Jugendlichen hinweisen. Auf die Probleme bei der Anästhesie von Kindern mit Autismus-Spektrum-Störung, infantiler Zerebralparese und Trisomie 21 gehen wir im Anschluss näher ein.

Exposure of children under 5 years to button batteries may result in severe corrosive injury, especially when they get stuck in the oesophagus. The injury is caused by the discharge current of the batteries. An increasing number of button battery ingestions have been described worldwide.The aim of this study was to describe incidence and complications after battery ingestion in children in Germany.Paediatric gastroenterologists and paediatric surgeons were asked to report complicated battery ingestions in children between 2011 and 2016 retrospectively. The survey was done using a structured questionnaire. In addition, button battery ingestion calls to a German poison centre were analysed retrospectively.In 116 cases the button battery was located in the oesophagus. Severe complications developed in 47 patients and 5 of these children died. Serious complications occurred also in children with removal of the button batteries within less than 3 h after the intake. The Freiburg poison centre received 258 paediatric ingestions of button batteries. Out of these, seven button batteries were stuck in the oesophagus and five in the nose causing corrosion injury.Serious complications and even death after button battery ingestion are described in Germany. Button batteries impacted in the oesophagus should be removed emergently to minimize corrosive injury. Because no symptoms or only slight discomfort are developed initially, awareness of button batteries as a unique corrosive hazard among the public and clinicians is an important requirement for prompt diagnosis and treatment resulting in a satisfactory outcome.

Drug errors occur in all areas of care. Due to age-group-specific characteristics and the need for dose calculation, the probability of errors in children increases compared to adults. The recognition of the fallibility of every supplier and the acceptance of security structures are essential. The article describes a catalogue of measures for drug safety suitable for everyday use.Medikamentenfehler kommen in allen Versorgungsbereichen vor. Bei Kindern steigt die Fehlerwahrscheinlichkeit im Vergleich zu Erwachsenen aufgrund altersgruppenspezifischer Besonderheiten und der erforderlichen Dosisberechnung. Wesentliche Aspekte sind: die Erkenntnis, dass jeder Versorger fehlbar ist, und die Akzeptanz von Sicherheitsstrukturen. Dieser Beitrag beschreibt einen Katalog alltagstauglicher Maßnahmen zur Medikamentensicherheit.

Both ingestion and aspiration of foreign bodies are common events in children. If a child had something in his mouth and thereafter respiratory or swallowing complaints occur, both aspiration and ingestion are possible causes. Both events can be immediately life threatening or, if a direct threat is absent, cause significant long-term impairments for the children. Therefore, the identification of any possible threat is essential. This paper identifies the diagnostic and therapeutic options and needs that will ensure the best possible safety and the least possible consequential harm.Sowohl Ingestions- als auch Aspirationsunfälle sind häufige Ereignisse bei Kindern. Sie können unmittelbar lebensbedrohlich sein oder bei fehlender direkter Bedrohung dennoch erhebliche langfristige Beeinträchtigungen für die Kinder verursachen. Der Beitrag zeigt die diagnostischen und therapeutischen Möglichkeiten und Notwendigkeiten auf, durch die eine bestmögliche Sicherheit und möglichst geringe Folgeschäden zu gewährleisten sind.

A difficult airway in childhood is very uncommon. Therefore, it will always be an unfamiliar and menacing situation for most anaesthetists. Knowledge of the individual pathology, associated anaesthesiological problems and possible solutions provide the basis for successful airway management. Endoscopical techniques are essential for the process. The following article shows how a difficult airway in childhood can be recognized and which anaesthesiological options exist to handle such a situation.