Pre-Anesthesia Assessment in Children with Down Syndrome: A Head to Toe Guide

Abstract

Purpose: The purpose of this project was to provide and assess an educational intervention for a multidisciplinary interprofessional collaborative sedation team at a children’s hospital in Anchorage, Alaska, Background: Children with Down syndrome (DS) are at a higher risk of adverse events when undergoing anesthetic care due to their many comorbidities. Providing safe and knowledgeable pre-anesthetic care that considers the unique health issues seen in children with Down syndrome allows providers to assess for possible anesthetic and post-anesthetic complications. Healthcare providers are often unaware of best practices for children with Down syndrome. This illustrates a gap in clinical practice that can be improved by updating education and informing providers of current evidence-based practice care for children with Down syndrome. Methods: An infographic and educational intervention regarding the pre-anesthetic assessment of children with DS was created based on available evidence. Education on the pre-anesthetic assessment was be performed via an online educational session and the infographic was provided to each participant. After the educational intervention, self-assessed knowledge, attitude, and motivation were assessed utilizing a retrospective post-then-pre survey. Results: Seven members of the pediatric team participated in the educational intervention and survey, with a 47.67% response rate. Following the educational intervention and survey, the sedation team reported increased knowledge in comparison to their pre-assessment. The sedation team also reported an increase in positive feelings about implementing evidence-based practices in the pre-anesthesia care of children with Down syndrome. Conclusions: This project revealed that education can positively impact a team’s positive feelings and intentions towards implementing evidence-based changes in practice. While limitations such as sample size impact the generalizability of these findings, providers noted that the intervention had an impact on their knowledge and attitudes towards providing specialized care for patients with Down syndrome.