View source for TYK375

__NOTOC__
The surgeon calls you at 3 a.m. about a 2 month-old boy who has IHPS,
diagnosed by history and ultrasound. He feels this is an emergent case given the
infant’s vomiting, metabolic derangement, and dehydration. You see the infant in
the ER, and the parents also feel strongly about taking their child to the OR. You
determine the BEST course of action is to:

a) Allow the child to continue oral intake for rehydration and delay the case until
morning

b) Delay the case until the infant has been medically stabilized and laboratory
data are close to normal

c) Proceed with the case, explaining the risks of rapid sequence induction to the
parents

d) Proceed with the case, but insist on a 20 mL/kg bolus of normal saline prior to
starting

e) Proceed with the case, but ensure awake suctioning of the stomach prior to
induction of anesthesia
<div class="mw-customtoggle-TYK_Answer" style="text-align: right; color:#0000ff">Click for Answer</div>
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-TYK_Answer">
==Answer==
Answer b. IHPS is a medical emergency, not a surgical emergency. The best
course of action is to rehydrate the infant with intravenous fluids (oral hydration
will prompt continuing emesis); ensure medical stabilization, fluid resuscitation,
and improvement of his metabolic state; and then proceed with surgery.
==Notes==
<references />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.
==Keywords==
:
</div>
----
----

<p style="text-align: center;">[[TYK374|<Prev Question]] --- [[TYK376|Next Question>]]</p>
<p style="text-align: center;">[[TYK About | About Test Your Knowledge]]</p>