More Ideas on Fixing the Pediatric Breathing Circuit

Since I raised the question , I feel the need to contribute myself. This is another approach to solve the problem of excessive drag on the Jackson-Rees or Closed Circuit when used in a pediatric surgery.

In this case, the breathing circuit tubing was securely knotted to the knot on the child's operating room clothes. Certain,pre-requisites would be obvious...namely nature of the surgery/surgical field, like ocular surgery ( like this case ) which would not interfere with the area of surgical interest.

Another caution to be exercised here would be to only knot after the child is sedated/paralyzed and to untie the knot before the patient comes out of anesthesia.

And last but not the least, a firm knot is all that is needed, over zealous fixation may end up increasing airway pressures for your patient and need I tell you why that is so very catastrophic with children.


Ashish K Khanna MD