Reader response
Myron Yaster MD
From Hector Rodriguez MD, Pediatric anesthesiologist (Retired)
The efficacy of chlorhexidine has been confirmed for long time. particularly during the placement of central lines. But we must not forget the potential for fires using alcohol containing solutions especially in head, neck, and chest cases. This prep requires that it be totally dry prior to the use of a Bovie, especially the hair. The fire from this prep, is practically invisible till you smell the burning, you can see the flames, or the drapes start burning.
From Jonathan Blank MD FAAA FAAPA, RWJBH Newark Beth Israel
Even after many years I always try and “perceive” that feeling of parents as they hand over their precious ones. I am always reminded and need to remind myself, that we come on parents in their most vulnerable times. I personally came to anesthesia with some family trepidation from an anesthetic gone bad back in the 60’s. - long before our “advances” in anesthesia monitoring. However, we all know that with the best monitoring and intentions, cases can go south. I try to tell parents that we are prepared but also this is 50:50 events to them and we must treat each patient and parental unit the same. We are all in a 100-% of the time!
From Johan Diedericks, Emeritus Professor and Head Department of Anaesthesiology University of the Free State, Bloemfontein, South Africa
Thank you for highlighting paediatric anaesthesia training in Africa. The Paediatric Anaesthesia Community of Southern Africa (PACSA) aims to support less trained practitioners far from big centres. They endorse the Paediatric Anaesthesia Handbook for Southern Africa. It is also used by Paediatric Anaesthesia Training in Africa (PATA). We developed this with contributions from Southern African authors. The contents are aimed at workers in both well and poorly resourced environments. It is freely available online (Hosted by the University of the Free State). Single chapter downloads can be done. It is a live document and after release a year ago, already an additional chapter was added. Accessible at https://monographs.ufs.ac.za/index.php/PASA/index
I Have been involved in South African paediatric anaesthesia throughout my career. Our centre is too small for a fully dedicated paediatric anaesthetist. I every week from the 1990’s did a paediatric cardiac and paediatric general surgery list. Other personnel similarly did both adult and paediatric anaesthesia.
Additional note from Dr. Diedericks: I was a founder and first president of PACSA (which functions as an interest group in the South African Society of Anaesthesiologists). Since retirement I had time to compile/edit/publish the Paediatric Anaesthesia Handbook for Southern Africa. It was a longtime dream of the PACSA enthusiasts. We directed it at African conditions where there are both areas of excellence with first world conditions and many areas with severe facility and personnel constraints. Personnel are often without good training or resources (and in many places anaesthesia is not provided by doctors). We aim to provide information useful to all levels of functioning. We created a structure where single chapters can be downloaded for free( as many rely on cell phones to acquire information).