• Pre-op Assessment Controversies (Paeds)
• URTI
• Risk of laryngospasm, bronchospasm, breath holding and desaturation
• Pre-op assessment (cancel if:)
• Purulent discharge
• Productive cough
• Fever (>38), malaise, irritable behaviour
• Consider the parent's view
• Examination
• Creps
• Wheeze
• Bronchial breathing
• Tachycardia
• SOB
• Viral exanthemas
• Delay beyond the maximal incubation period if possible
• Incubation periods
• Varicella
• 10-21 days
• Measles
• 7-18 days
• Rubella
• 14-23 days
• Mumps
• 15-22 days
• Immunisation
• Usually fine to anaesthetise children post-vaccination
• Do not delay vaccination in favour of elective surgery
• Can give immunisations to children under anaesthetic
• Safe to immunise after surgery
• Heart murmurs
• Parameter
• Innocent
• Pathological
• Symptoms
• Asymptommatic
• Symptommatic
• Timing
• Eary systolic/continuous
• Diastolic, pansystolic or late systolic
• Quality
• Blowing, vibratory
• Variable, harsh
• Thrill
• Never
• Sometimes
• Postural variation
• Often
• Rarely (HOCM increases on standing)
• Referral
• Any child under 1 with a murmur
• Associated with syndrome (eg Down's)
• FHx of SIDS
• Ix
• ECG
• RVH, LVH
• TTE
• Compensated and corrected simple defects can be done safely at non-specialist centres, more complex circulations should be done at a specialist centre where possible
• CEACCP
  Link:ceaccp.oxfordjournals.org/content/11/6/214.full.pdf?sid=edcf844a-2228-4abb-9f3d-edadea7f6de2