Knowing which risks may come into play before or during surgery is especially important where children are concerned. Implementation of a screening questionnaire detailed in the latest AANA Journal helps anesthesia professionals identify children with symptoms of sleep-disordered breathing (SDB) before undergoing a general anesthetic.
The article, "Snoring, Trouble Breathing, Un-Refreshed (STBUR) Screening Questionnaire to Reduce Perioperative Respiratory Adverse Events in Pediatric Surgical Patients: A Quality Improvement Project," appears in the August 2015 issue of the journal, published by the American Association of Nurse Anesthetists (AANA).
A main challenge to addressing SDB in children about to undergo surgery is the lack of awareness of the risks and parents who underestimate their child's condition. Lead author Karrey L. Terry, CRNA, DNP, says, "Parents are often unaware of the potential problems related to their child's snoring. Recognition of this condition is of utmost importance, as children have died after routine tonsillectomies after receiving too much pain medication."
Because SDB manifests itself in a patient's respiration, anesthesia professionals such as Certified Registered Nurse Anesthetists (CRNAs) are in a perfect position to uncover undiagnosed conditions such as SDB prior to surgery in an effort to head off any respiratory complications during anesthesia. The STBUR questionnaire provides five questions that help to identify SDB prior to surgery. The importance of identifying those at risk is paramount: The likelihood of developing a perioperative respiratory adverse event (PRAE) increases three-fold in the presence of any three STBUR symptoms, and by 10-fold when all five symptoms are present.
Including the STBUR questionnaire in the pre-anesthesia interview serves to raise awareness of potential risks, and allows anesthesia professionals to modify their airway and anesthesia plans toward safer practices. "We are looking to improve safety by creating evidence-based standards of care," says Terry.
American Association of Nurse Anesthetists (AANA)