Head of Department of Anaesthesiology, Resuscitation and Intensive Care, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
The educational algorithm very accurately describes the real clinical situation a paediatric anaesthetist is repeatedly confronted. It realistically simulates typical situations and conditions that accompany a relatively frequent diagnosis which is often downplayed, however, brings a number of serious risks even for an experienced anaesthetist. Fully in line with modern trends, current acute and intensive medicine primarily emphasizes the safety of the procedure without unnecessary restrictions to the patient. It properly takes into account the entire process from the patient´s admission to hospital through an evaluation of their current health status, an effective premedication, the administration of anaesthesia and keeping the airways unblocked up to the safe post-operative care. A decision-making algorithm is logical, enough space is dedicated to each part of the performance. It also includes a brief and clear explanation why this or that particular procedure is correct. The above mentioned model example is a copy of a real situation, that should be correctly handled by each doctor dedicated to pediatric anesthesia and intensive care. Practicing the correct procedure is the best preparation for the actual situation. Unlike making decisions according to the theoretical algorithm you usually can not “go a step back“ in real life.
The algorithm is dedicated to a rare neurological disease, congenital recessive form of myotonia congenita Becker. The algorithm logically leads from the first contact with the patient through the entire perioperative period up to the potential discharge from the hospital. Takes into account all stages of the decision-making process with an emphasis on the key factors that can complicate the health condition of the patient and operating performance. The individual steps of the algorithm are logical and smoothly follow each other. In addition to the correct answers, it suggests a possible common mistakes and incorrect procedure. The specified model belongs among the typical clinical situation. A great advantage of the algorithm is the fact that it confronts the doctor with realistically created situations of rare, but serious, disease. It is possible at any time to "step back" from mistakes which would mean a serious complication in real situation, and it allows to learn and choose the correct procedure. In real life this is not possible. Another advantage of the algorithm is the theoretical information/note, which increases the level of knowledge about this rare disease.