Day-Care / Ambulatory Paediatric Anaesthesia and Common Elective Minor/Intermediate Procedures — WACS Viva & Clinical Scenarios (Paediatrics & Day Care)

Exam-style day-care / ambulatory paediatric anaesthesia and common elective minor/intermediate procedures viva scenarios with examiner probes and model answers…

Scenarios covered

• SCENARIO 1: A 4-year-old boy is scheduled for elective bilateral myringotomy, grommet insertion, and adenoidectomy on the morning day-case list. Preoperative history reveals severe snoring, nocturnal apnoeas, and mouth breathing. How do you evaluate his eligibility for day-care discharge, what anaesthetic technique do you adopt, and how do you monitor for post-obstructive pulmonary oedema?
• SCENARIO 2: A 7-week-old infant born at 33 weeks post-menstrual age (weight 3.8 kg, post-conceptual age 40 weeks) is booked for day-case left inguinal herniotomy. The mother lives 45 km away in a rural village without private transport. How do you address this case from the perspective of day-case eligibility, perioperative apnoea risk, and admission planning?
• SCENARIO 3: Detail the modern evidence-based preoperative fasting guidelines (liquids, breast milk, formula, solids) for paediatric day surgery. What are the physiological and psychological hazards of prolonged preoperative fasting in tropical West African environments, and how do you prevent them?
• SCENARIO 4: A 3-year-old girl is scheduled for day-case excision of a congenital melanocytic nevus under general anaesthesia. She had a mild clear rhinorrhoea and afebrile 'cold' for the past 3 days. What criteria determine whether to proceed with or cancel day surgery in a child with an upper respiratory tract infection (URTI)?