• Reimer, Eleanor

    Titles

    Investigator, BC Children's Hospital
    Pediatric Anesthesiologist, BC Children's Hospital
    Clinical Professor and Head, Division of Pediatric Anesthesiology, Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

    Degrees / Designations
    MD, FRCPC
    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Phone
    604-875-2711
    Fax
    604-875-3221
    Lab Phone
    Assistant
    Denise Taylor
    Assistant Phone
    604-875-2711
    Mailing Address

    BC Children's Hospital
    Room 1L7
    4480 Oak Street
    Vancouver, BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Safety in anesthesia
    • Procedural sedation
    • Pain management
    Summary

    My primary research interest is safety in anesthesia delivery. This has a very wide scope but my most recent projects focus this interest. A growing area of anesthesia practise is care of children during diagnostic procedures. These procedures may be painful or only require the child to be still. Investigating the safe administration of propofol, a primary anesthetic agent, will provide guidelines for other acute care physicians to use it in their practise.

    My other project is the first examination of how well we prepare our families to care for children at home after surgery. We are starting by designing a questionnaire for evaluation. This will hopefully follow with appropriate interventions to increase safe transition of care.

    Current Projects

    Information Transfer between Parent and Healthcare Providers
    The period following discharge from hospital is a vulnerable time for patients. Discharge is a period of transition from hospital to home that involves the transfer in responsibility from inpatient provider to the patient, parent and primary care physician. Self-care or parental-care responsibilities also increase in number and importance, presenting new challenges for patients and their families.

    Under these circumstances, ineffective planning and coordination of care can facilitate adverse events. Deficits in information transfer between parents and health care providers are common and potentially dangerous. Poor communication and inadequate transfer of clinical information can lead to adverse events in the period immediately following discharge from hospital.

    With this research study we aim to determine if the current practices of information transfer between parents and health care providers is adequate or if parents lack the knowledge to avoid potential adverse events once their child is discharged from hospital.

    Propofol Sedation
    Children are increasingly given sedation to facilitate non-painful or minimally invasive diagnostic and therapeutic procedures. Oral sedation results in high failure and complication rates. The intravenous anesthetic agent propofol, which has rapidly titratable and predictable sedative characteristics, has gained popularity for sedation procedures in a number of settings. Over 80% of these sedations are performed by non-anesthesiologists. The risks of complications during sedation exceed those experienced during general anesthesia, with a twelvefold increased risk of mortality when sedation is administered outside the operating room.

    While propofol has many advantages, rapid administration of a loading dose causes significant respiratory depression by impairment of the chemoreceptor response to carbon dioxide (CO2). Respiratory depression may lead to hypoxemia and the need to provide manual positive pressure ventilation. However, if propofol is administered less rapidly, spontaneous ventilation is maintained as the accumulation of CO2 in the blood from ongoing metabolic processes continues to stimulate the chemoreceptors despite their impaired sensitivity.

    We aim to identify a clinical dosing schedule for the administration of propofol in children that will ensure rapid onset of sedation while maintaining spontaneous ventilation.

    Selected Publications

    Refereed Publications
    Reimer EJ, Dunn GS, Montgomery CJ, Sanderson PM, Scheepers LD, Merrick PM. The effectiveness of clonidine as an analgesic in paediatric adenotonsillectomy. Can J Anaesth 1998; 45: 1162.

    Bevan JC, Reimer EJ, Smith MF, Scheepers LdeV, Bridge HS, Martin SR, Bevan DR. Decreased mivacurium requirements and delayed neuromuscular recovery during sevoflurane anesthesia in children and adults. Anesth Analg 1998;87:772-8.

    Bevan JC, Bevan DR, Reimer EJ, Smith MF, Scheepers L, Bridge HS, Martin SR. Reduction of mivacurium requirements by sevoflurane in adults and children. Anesth Analg 1998;86:5429.

    Bevan DR, Kahwaji R, Ansermino JM, Reimer EJ, Smith MF, O’Connor, SAR, Bevan JC. Residual block after mivacurium with or without edrophonium reversal in adults and children. Anesthesiology 1996;84:362-7.

    Bevan JC, Tousignant C, Stephenson C, Blackman L, Reimer E, Smith MF, Bevan DR. Dose responses for neostigmine and edrophonium as antagonists of mivacurium in adults and children. Anesthesiology 1996;84:354-61.

    Video
    Reimer EJ, Rosen HD. “About Your Operation” Clinical Evaluation of a New Teaching Programme for Children Having Surgery and Dental Procedures.” Educational preoperative video for parents and children

    Book Chapter
    Bevan JC, Stephenson C, Smith MF, Reimer EJ, Blackman L, Bevan DR. (Abstract in chapter) Recovery and reversal of mivacurium neurmuscular blockade with neostigmine and edrophonium in paediatric patients. In: Muscle Relaxants. Physiologic and Pharmacologic Aspects, Tokyo, New York, London: Springer-Verlag 1995. P358.

    Grants
    Honours & Awards
    Research Group Members

    The research manager research assistants and research fellows of the Anesthesia Research Team.