Paediatric Non-Operating Room Anaesthesia (NORA) and Sedation in Diagnostic/Interventional Suites — WACS Viva & Clinical Scenarios (Paediatrics & Day Care)

Exam-style paediatric non-operating room anaesthesia (nora) and sedation in diagnostic/interventional suites viva scenarios with examiner probes and model…

Scenarios covered

• SCENARIO 1: A 2-year-old child weighing 12 kg is scheduled for a 45-minute brain MRI scan for developmental delay and intractable seizures. The MRI scanner is a 3.0 Tesla unit located in a detached diagnostic imaging building. Outline your pre-anaesthetic evaluation, MRI safety screening, choice of anaesthetic technique (deep sedation vs general anaesthesia), equipment preparation, and remote monitoring protocols.
• SCENARIO 2: A 3-year-old child with a known button battery lodged in the upper oesophagus for 12 hours is brought to the endoscopy suite for emergency extraction. The gastroenterologist suggests performing the procedure under light ketamine sedation without an endotracheal tube. Critically evaluate this proposal and outline your complete anaesthetic management.
• SCENARIO 3: A 5-year-old child with acute lymphoblastic leukaemia is scheduled for daily fractionated external beam radiotherapy for 4 consecutive weeks. Describe your anaesthetic strategy, focusing on repeated anaesthetic exposure, choice of sedative/anaesthetic agents, airway maintenance, vascular access maintenance, and mitigation of the risks of chronic daily fasting.
• SCENARIO 4: While a 4-year-old child is undergoing a brain MRI under Propofol TIVA with a natural airway and nasal cannula oxygen, the pulse oximeter suddenly displays SpO₂ dropping to 78%, and capnography shows loss of waveform. The child is deep inside the MRI bore. Detail your immediate, step-by-step crisis management protocol.