Preoperative pregnancy testing in my institution for the majority of surgical cases:

A 4-year-old patient has come from a significant distance for hydrocele repair. The parents are Non-English speaking and need an interpreter - you find out the child ate breakfast 5 hours ago. You perform point of care ultrasound (US) of the gastric antrum which demonstrates an empty antrum in both supine and right lateral decubitus position. A nomogram (link below) is used to calculate the volume of gastric contents using the cross-sectional area measured around the muscularis with the patient’s age. The volume is less than 1.5 ml/kg in the right lateral decubitus position. This finding suggests low risk of aspiration. {https://www.gastricultrasound.org/en/special-patients/} What would be your next plan of action?

When personally intubating an otherwise healthy 2-week-old term neonate with no indication of potential difficult airway for elective surgery, which of the following techniques do you most frequently attempt for your initial laryngoscopy?

(Pre anesthesia pregnancy screening: an imperative or a bubbe meise? Ethical considerations part one (substack.com) Reference: Jackson S, Hunter J, Van Norman GA. Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review. Anesthesia and analgesia 2024;138(5):980-991. DOI: 10.1213/ane.0000000000006669.) - - In the light of recent articles on routine preoperative pregnancy testing our current institutional practice is:

As opposed to paper anesthesia records, electronic pediatric anesthesia records can now be accessible in real-time by parents. How and when this information is presented can introduce new challenges. In context of the Cures Act and the lawful freely sharing of information, how has your practice adapted? (https:/pubs.asahq.org/monitor/article/85/2/e3/115119/Open-Anesthesia-Records-Guidance-for-Anesthesia__;!!Ls64Rlj6!xjqV8KQA6qLl6WFfUIl0QpGLBupbqSHRDctOWwx3ecpRloriG0zIPxP4eQrfb4biag7ghbBIaG2NAiDzagJ-b1PKgA$)

Our current stand of perioperative use of methadone:

A 5 year old with 20% TBSA burn is coming to the OR for a debridement and dressing change. The patient has been receiving continuous postpyloric tube feeds on the floor as confirmed by imaging the day before surgery. An LMA is planned. How many hours should this patient remain NPO prior to the surgery?

As indicated by a recent PAAD, routine or at least more common EEG monitoring is likely on the horizon in anesthetic management of patients, including infants and children. In my practice, I (https://ronlitman.substack.com/p/eeg-to-guide-the-depth-of-anesthesia?utm_source=publication-search)

In light of the IV fluid shortages (check all that apply):