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      Pediatric anesthesia in North America

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          Abstract

          Background and Objectives

          This educational review outlines the current landscape of pediatric anesthesia training, care delivery, and challenges across Canada, Barbados, and the United States.

          Descriptions and Conclusions

          Approximately 5% of Canadian children undergo general anesthesia annually, administered by fellowship‐trained pediatric anesthesiologists in children's hospitals, general anesthesiologists in community hospitals, or family practice anesthesiologists in underserved regions. In Canada, the focus is on national‐level evaluation and accreditation of pediatric anesthesia fellowship training, addressing challenges arising from workforce shortages, particularly in remote areas. Barbados, a Caribbean nation, lacks dedicated pediatric hospitals but has provided pediatric anesthesia since 1972 through anesthetists with additional training. Challenges in its development, common to low‐middle‐income countries, include inadequate infrastructure and workforce shortages. Increased awareness of pediatric anesthesia as a sub‐specialty could enhance perioperative care for Barbadian children. Pediatric anesthesia encompasses various specialties in the United States, with pediatric anesthesiologists playing a foundational role. Challenges faced include recruitment and retention difficulties, supply‐chain shortages, and the proliferation of anesthesia sites, all impacting the delivery of modern, high‐quality, and cost‐effective patient care. Collaborative efforts at national and organizational levels strive to improve the quality and safety of pediatric anesthesia care in the United States.

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          Most cited references9

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          Outcomes from wake up safe, the pediatric anesthesia quality improvement initiative.

          Wake Up Safe, a Patient Safety Organization founded by the Society for Pediatric Anesthesia, collects data on serious adverse events along with demographic data from all pediatric patients receiving anesthesia care at participating institutions. This report reviews all events occurring between 2010 and 2015 and focuses on common adverse events that are anesthesia-related.
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            Is Open Access

            Major Congenital Malformations in Barbados: The Prevalence, the Pattern, and the Resulting Morbidity and Mortality

            Objectives. To study the prevalence and the pattern of major congenital malformations and its contribution to the overall perinatal morbidity and mortality. Methods. It is a retrospective population based study. It includes all major congenital malformations in newborns during 1993-2012. The data was collected from the birth register, the neonatal admission register and the individual patient records at the Queen Elizabeth Hospital where over 90% of deliveries take place and it is the only facility for the care of sick newborns in this country. Results. The overall prevalence of major congenital malformations among the live births was 59/10,000 live births and that among the stillbirths was 399/10,000 stillbirths. Circulatory system was the most commonly affected and accounted for 20% of all the major congenital malformations. Individually, Down syndrome (4.1/10, 000 live births) was the commonest major congenital malformation. There was a significant increase in the overall prevalence during the study period. Major congenital malformations were responsible for 14% of all neonatal death. Conclusions. Less than 1% of all live newborns have major congenital malformations with a preponderance of the malformations of the circulatory system. Major congenital malformations contribute significantly to the overall neonatal morbidity and mortality in this country.
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              Anaesthesia in Barbados.

              To describe the anaesthesia services in Barbados: to present the major challenges confronting the Anaesthesia Department of the government-owned Queen Elizabeth Hospital (QEH): and to describe the Department's approaches to optimise safety and cost-effectiveness of anaesthesia at QEH.
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                Author and article information

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                Journal
                Pediatric Anesthesia
                Pediatric Anesthesia
                Wiley
                1155-5645
                1460-9592
                September 2024
                March 11 2024
                September 2024
                : 34
                : 9
                : 906-918
                Affiliations
                [1 ] Department of Anesthesia and Pain Medicine The Hospital for Sick Children Toronto Ontario Canada
                [2 ] Department of Anesthesiology, Pharmacology & Therapeutics BC Children's Hospital Vancouver British Columbia Canada
                [3 ] The Bayview Hospital Bridgetown Barbados
                [4 ] The Queen Elizabeth Hospital Bridgetown Barbados
                [5 ] Department of Anesthesiology University of Florida College of Medicine Gainesville Florida USA
                [6 ] Boston Children's Hospital Harvard Medical School Boston Massachusetts USA
                [7 ] Department of Anesthesiology Loma Linda University Loma Linda California USA
                Article
                10.1111/pan.14872
                7c563cb5-34e9-4653-a4be-c7cbf32b26a1
                © 2024

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