From Simon Sommerhuber MD, Klinikum Klagenfurt, Austria on dexamethasone vs hydrocortisone and addisonian crisis
Regarding your PAAD about Addisonian crisis prevention and your discussion with our colleague von Unger-Sternberg - I wanted to show you this summary of the pediatric PONV prophylaxis recommendations of the fourth consensus guideline for the management of PONV.(1) I cannot imagine that there are many children that do not have at least one risk factor, which means that they all should get dexamethasone. But alas, we do have to plan for medicine practiced beyond, better than or in ignorance of guidelines. (figure from reference)
Reference
Gan TJ, Belani KG, Bergese S, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesthesia & Analgesia 2020;131(2):411-448. DOI: 10.1213/ane.0000000000004833.
From Lynn Ferrari MD Boston Children’s Hospital on TEF
LOVE the precordial stethoscope! Still require our pediatric anesthesia fellows to use it during suspension laryngoscopy with spontaneous ventilation. They find it a novel and enlightening means of monitoring ventilation before changes in pulse oximetry occur.
I still have the one that was given to me in 1987 at the beginning of my pediatric anesthesia fellowship.