5. Smooth out the post-op process
The coping plan extends to the PACU, which is a challenging place to
be for many children with ASD. To minimize emergence agitation, we
make sure the drapes are drawn, the lights are dim, the TV is off and
the parents are at the bedside, with the stuffed animals or comfort
items in the area before the patient wakes up. The IV saline is locked
from the OR and is removed as early as possible once in recovery.
Analgesia, antiemetics and fluids are given in the OR. If the patient likes
music, we have it playing. If the patient feels more comfortable with a
weighted blanket, we supply one. Ultimately, timely discharge when
appropriate allows for patients to be safely sent home without becom-
ing agitated in recovery.
The big payoff
These interventions have been practice-changing in our hospital.
Providers feel empowered to do better, and they see how it makes
a difference.
Maybe even more than other patients, children with ASD deserve
and require the best we have to offer. With these patients, there are no
shortcuts if you want to provide excellent care.
OSM
3 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 9
Dr. Whippey (whippeya@gmail.com) is a pediatric anesthesiologist and an
assistant clinical professor of anesthesia at McMaster University in Hamilton,
Ontario. She speaks widely on the care of autistic patients.
