Maximum permissible time limits for dynamic monitoring of young children in a surgical hospital if acute appendicitis is suspected?

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4. Maximum permissible time limits for dynamic monitoring of young children in a surgical hospital if acute appendicitis is suspected?

Complication and perforation rates are similar for patients undergoing surgery within 6 hours of admission compared to those undergoing surgery between 6 and 16 hours after admission to the hospital. The majority of pediatric surgeons perform appendectomy within 8 hours after admission. It should be emphasized that the delay in the emergency operation is permissible only with uncomplicated acute appendicitis and after an expedient resuscitation, all the patients with appendicitis must undergo timely surgical exploration.

5. Task: a child of 1 year, weight 10 kg, was admitted to a surgical hospital with a picture of peritonitis, sick for a day. On examination, the condition is severe due to intoxication and hyperthermia up to 39.5. There are positive symptoms of peritoneal irritation, passive protective tension of the anterior abdominal wall muscles. Marked oliguria, blood leukocytes 20,000, rod-shaped shift to the left,

A. Assign preoperative training

Preoperative antibiotics are given to children with suspected appendicitis and stopped after surgery if no perforation exists. Patients presenting with perforated appendicitis may be volume depleted and require aggressive fluid resuscitation. The combination of ampicillin, clindamycin, and gentamicin is administered to treat infection from aerobic and anaerobic organisms

B. Duration of preoperative preparation, criteria for its effectiveness

An appendectomy is often an emergency surgery. Child may not have a lot of time to get ready for it. The healthcare team will want to know when the child last ate. That’s because having food in the stomach can cause problems when the child is under anesthesia. If the surgery is planned ahead of time, ask the healthcare provider when the child should stop eating and drinking beforehand.

Before the procedure starts, the healthcare team may give the child a shot of medicine to help him or her relax. The child will also have an IV (intravenous) line placed into a vein so other medicines can be given. This is how the child will be put to sleep for the surgery.           

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