title: Difficulties with assessment and management of an infant's distress in the postoperative period: Optimising opportunities for interdisciplinary information-sharing.
abstract: OBJECTIVE
  The importance of accurate paediatric patient assessment is well established but under-utilised in managing postoperative medication regimens.
  
  
  METHODS
  Data for this case report were collected through observations of clinical practice, conduct of interviews, and retrieval of information from the medical record. This case report involving a hospitalised 1-year-old boy demonstrates the difficulties associated with assessing and managing postoperative distress, including pain and other clinical conditions related to the surgical procedure.
  
  
  RESULTS
  Postoperatively, there were difficulties in managing pain and an episode of over-sedation, occasioning opiate reversal with naloxone. In addition, he had decreasing oxygen saturation and increased work of breathing. X-ray showed changes consistent with either atelectasis or aspiration, and he was commenced on antibiotics. The patient experienced respiratory distress and required intervention from the medical emergency team.
  
  
  CONCLUSIONS
  This case demonstrated the importance of comprehensive assessment and careful consideration of alternative causes of an infant's distress using the results of assessment tools to aid decision-making. Communication moderates effective patient care, and more favourable outcomes could be achieved by optimising interdisciplinary information-sharing.
authors.affiliation: Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC, Australia.
authors.forename: Carlye
authors.initials: C
authors.lastname: Weiner
authors.affiliation: Children's Pain Management Service, The Royal Children's Hospital, Parkville, VIC, Australia.
authors.forename: Sueann
authors.initials: S
authors.lastname: Penrose
authors.affiliation: Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC, Australia; Faculty of Health, School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia; The Royal Melbourne Hospital and The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.affiliation: Clinical Pharmacology Unit, Department of Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Australian Paediatric Pharmacology Research Unit (APPRU), Murdoch Childrens Research Institute and The Royal Children's Hospital, Melbourne, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Noel
authors.initials: N
authors.lastname: Cranswick
authors.affiliation: Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC, Australia.
authors.forename: Ellie
authors.initials: E
authors.lastname: Rosenfeld
authors.affiliation: Nursing Research, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Haematology, Departments of Nursing and Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Childrens Research Institute, Parkville, VIC, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Newall
authors.affiliation: School of Nursing and Midwifery, Monash University, Clayton, VIC, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.affiliation: Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC, Australia.
authors.forename: Narelle
authors.initials: N
authors.lastname: Borrott
authors.affiliation: Nursing Research, The Royal Children's Hospital, Melbourne, VIC, Australia; Departments of Nursing and Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kinney
keywords: Pharmacoepidemiology and drug safety; analgesia; communication; medication management; pain; postoperative care