Pediatric Anesthesiology
Induction Principles and Technics - 3

Monitoring During Induction

The most important - the best - monitor is the anesthesiologist. In a very real sense, it may be said that the anesthesiologist IS THE monitor. In fact, the sight, hearing and touch of the alert, vigilant anesthesiologist comprise an entirely sufficient monitor for initiation of inhalational induction in a healthy but anxious child. As the child loses consciousness, the experienced pediatric anesthesiologist will often recognize and correct minor episodes of upper airway obstruction before a pulse oximeter would have demonstrated any change. Once the child has lost consciousness, the next most important monitors, a precordial stethoscope and a pulse oximeter probe may be gently applied. Subsequently, blood pressure cuff and ECG leads may be added.
A sick infant or child, especially if unstable, should have these and any other appropriate monitors applied before induction.

Greg Gordon MD