SAAD Digest 

March 2025
Volume: 41
Issue: 1
DOI: 10.63507/IZSS3033

Title: Pilot video consultations to assess high BMI paediatric patients’ suitability for the provision of dental treatment under general anaesthesia at a Day Surgery Unit

Author(s): B. Tailor, N. Seth, N. Bhujel. 

Abstract: 

Background
Childhood obesity is an increasing healthcare challenge as these children can have increased risk of peri-operative complications. Video consultations were introduced for children and young people between the ages of two and 16 years who were clinically overweight, with a body mass index (BMI) centile above 93. Suitability for treatment at the Guy’s and St Thomas’ NHS Foundation Trust Day Surgery Unit (DSU) was assessed using this pilot service. Patients assessed to be at high risk of complications were triaged to receive treatment at an in-patient general anaesthetic (GA) facility.

Aim
To enhance the safe delivery and recovery of GA for overweight paediatric patients requiring dental treatment.

Method
All children planned for dental treatment under GA with a BMI over 93, calculated using the NHS BMI calculator, and an ASA (American Society of Anesthesiology) classification score I or II were booked for a pre-general anaesthetic assessment via video consultation. We collected patient demographics and outcome in terms of whether their GA was suitable for a DSU or an in-patient setting.

Results
Twenty-seven patients had video consultations. Twenty patients were deemed suitable for GA at DSU and seven were treated in an in- patient setting. There were no adverse events under GA. New departmental protocols were implemented to signpost staff and patients to the options and pathways to access general anaesthetic care in the DSU or in-patient setting.

Conclusion
Video consultation can be a suitable alternative to face-to-face pre-operative assessment for high BMI paediatric patients.

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Articles from Digest 41(1)