Smartphones in the Operating Room: Distraction or Diagnostic Aid? A Case of Newly Diagnosed Wolff-Parkinson White in a Pediatric Patient Having Bronchoscopy Under General Anesthesia.

Abstract

A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded. In the recovery room, initial 12-lead ECG showed sinus tachycardia. Shortly after, a presumptive diagnosis of Wolff-Parkinson White was given upon review of the smartphone recordings by the pediatric cardiologist on service. Twelve lead ECG was repeated which showed intermittent Wolff-Parkinson White. This case highlights 2 points. First, any prolonged or sustained pediatric dysrhythmia revealed during anesthesia warrants further investigation and should not be assumed secondary to an anesthetic drug. Second, ubiquitous smartphones are an excellent tool for capturing data that the monitor is unable to capture.