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Anesthesia and Sedation in the Pediatric and Congenital Cardiac Catheterization Laboratory

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Checklists Preprocedure 1. Patient identification, diagnosis, intended procedure, documentation of a history and physical examination and a signed consent form 2. Documentation of allergies, including drug, food, latex and contrast 3. Airway assessment 4. Verified NPO status 5. Confirmed plan for patient monitoring 6. Room setup including the need for transesophageal echocardiography (TEE), inhaled nitric oxide (iNO), and rotational angiography 7. Special medications required, including but not limited to antibiotics, antiarrhythmics, anti-coagulants, vasopressors, stress-dose steroids 8. Availability of implanted devices, including pacemakers and implantable cardioverter defibrillators 9. Bleeding risks, including the presence of a type and screen or crossmatch and the need for immediate blood in the catheterization laboratory 10. Anesthesia plan (general anesthesia versus monitored anesthesia care [MAC] with spontaneous ventilation) 11. Consideration of the need for extracorporeal membrane oxygenation (ECMO) support and surgical backup 12. Access plan, sheath size and previous access issues 13. Plan for postoperative recovery — home, regular floor or ICU 14. Pregnancy test as necessary Intraprocedure 1. Patient identification, diagnosis, and procedure 2. Allergies, including drug, food, latex, and contrast 3. Antibiotic requirements 4. Heparin plan 5. Blood availability 6. Availability of vasopressor medications and resuscitation equipment 7. Disposition post-procedure (inpatient unit, intermediate-care unit, or intensive-care unit)

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