A 5-week-old baby with projectile vomiting is listed for pyloromyotomy. Venous gas shows pH 7.55, chloride 84 mmol/L, potassium 2.8 mmol/L and

Question

A 5-week-old baby with projectile vomiting is listed for pyloromyotomy. Venous gas shows pH 7.55, chloride 84 mmol/L, potassium 2.8 mmol/L and bicarbonate 38 mmol/L. The surgeon asks for urgent theatre because the baby has not fed for 12 hours. What is the most appropriate management?

Accepted Answer

Correct dehydration and electrolyte disturbance before anaesthesia

Answer

Treat alkalosis with sodium bicarbonate

Answer

Proceed immediately with rapid sequence induction

Answer

Give oral potassium and anaesthetise in one hour

Answer

Use spinal anaesthesia to avoid aspiration risk

Pyloric stenosis optimisation — FRCA Final MCQ

A 5-week-old baby with projectile vomiting is listed for pyloromyotomy. Venous gas shows pH 7.55, chloride 84 mmol/L, potassium 2.8 mmol/L and bicarbonate 38 mmol/L. The surgeon asks for urgent theatre because the baby has not fed for 12 hours. What is the most appropriate management?