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Consider avoiding dexamethasone/steroids as patients with significant tumour bulk may be at risk of tumour lysis syndrome. Discuss with the haematologist.
Case description here of tumor lysis syndrome following dexamethasone dx.doi.org/10.1111/j.1460...
Case description of a death from tumor lysis syndrome following a tonsillectomy and unrecognised malignancy dx.doi.org/10.1056/NEJMra...

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If the patient prefers an IV induction, local anesthetic cream is usually placed on the portacath site prior to accessing it.

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If a portacath is present, it will usually be accessed prior to the LP, after gas induction.

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Spontaneous ventilation with a mask in the lateral position.

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Ask the patient or their parent how they are usually induced. They would have had many procedures performed prior to this episode.

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