Knowing which risks might come into play before or during surgery is especially important where children are concerned. Implementation of a screening questionnaire detailed in the August 2015 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 journal, published by the American Association of Nurse Anesthetists.
A primary 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. “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,” says lead author Karrey L. Terry, CRNA, DNP, an assistant professor at the University of Colorado School of Medicine and staff nurse anesthetist at Children’s Hospital Colorado in Denver. At the time of this project, she was a doctorate of nursing practice student at the University of Colorado College of Nursing.
Because SDB manifests itself in a patient’s respiration, anesthesia professionals are in a perfect position to uncover undiagnosed conditions such as SDB before surgery to head off respiratory complications during anesthesia. The STBUR questionnaire provides five questions that help to identify SDB prior to surgery. They are:
Does your child snore more than half the time?
Does your child snore loudly?
Does your child have trouble breathing or struggle to breathe?
Does your child ever stop breathing during the night?
Does your child wake up feeling unrefreshed?
The importance of identifying those at risk is paramount: The likelihood of developing a perioperative respiratory adverse event increases threefold in the presence of any three STBUR symptoms and by tenfold 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.
For more information on the STBUR questionnaire and the AANA Journal article, visit http://www.aana.com/sdb-patients.