Page 33 - CASA Bulletin of Anesthesiology Vol 9 (4) 2022 (3)

Vol. 9, No 4, 2022

In the pre- and perioperative unit of our hospital, child life specialists and anesthesiologists
work together to provide an individualized plan that mitigates the potential for medical
traumatization while keeping patient safety at the forefront of our plan.

By providing developmentally appropriate preparation, the child life specialist’s goal is to
decrease patients’ level of anxiety or stress regarding their procedure.

In order to mitigate any unknown or unanticipated stressors during the transition to the
anesthesia induction setting, child life specialists conduct thorough psychosocial assessments
prior to any procedure requiring anesthesia. They assess patients’ level of understanding and
clear misconceptions about their medical encounter that may impede coping; they also work with
parents or caregivers to find out what their child’s typical response is when separated from them.
Anesthesiologists, combined with their developmental assessment, determine what type of pre-
op medications may be needed, if any, to promote positive coping and to maximize safety for all
involved.

Child life specialists are able to use either directed or undirected medical play using real or
play medical materials, depending upon developmental assessment, to promote familiarization
and desensitization to relevant materials used during patients’ medical encounter. Throughout
transition away from pre-op area and caregivers to the anesthesia induction setting, our child life
specialists frequently accompany the patient back to the induction area in order to continue
providing distraction and support. Using play or alternative distraction methods, in combination
with anxiolytics if needed, help minimize risks throughout anesthesia induction by encouraging
compliance and minimizing unnecessary movement
Here are some tips from our child life specialists:

Tips when working with pediatric patients:

Create positive relationships with kids!

Child life specialists assess patients by playing and talking with them. They provide different
tools such as toy carts, iPads, fidgets, etc. to help children to relax.

Offer choices!

If it’s appropriate, offering kids the choice of going off to sleep sitting up instead of lying
down can help promote a feeling of control over their situation, which can encourage
compliance. Additionally, allowing patients to bring a comfort item (favorite stuffed animal,
blanket, or toy) to the induction setting can encourage comfort and compliance as well.

Kid- friendly!

An easy way to make the anesthesia mask and induction more “kid-friendly” is to incorporate
familiar items like stickers or markers to decorate the mask, while simultaneously promoting
familiarization and desensitization to it. The smell of the anesthesia gas can also be a significant
stressor for pediatric patients, so most child life specialists offer “flavors” of Chapstick to put

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