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. 2020 Apr 21;8(4):e2735.
doi: 10.1097/GOX.0000000000002735. eCollection 2020 Apr.

Pediatric Procedural Sedation in the Emergency Setting

Elizabeth A Lucich  1   2 , Nicholas S Adams  1   2 , Paige C Goote  3 , John A Girotto  1   2   4 , Ronald D Ford  1   2   5
Affiliations

Pediatric Procedural Sedation in the Emergency Setting

Elizabeth A Lucich et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Pediatric emergency department (ED) visits are common. Many are due to injury, which require procedural treatments with sedation. There are many well researched independent predictors of adverse events for pediatric procedural sedation. The duration of sedation as a predictor of adverse events has not been well studied. This study aims to determine the complication rate and severity of procedural sedation as well as determine if the duration of sedation is correlated with an increased risk of complications.

Methods: After Institutional Review Board approval, a retrospective study was performed on all patients seen at Helen Devos Children's ED who received sedation from August 1, 2011, to August 15, 2016. Study variables included age, weight, type of procedure, American Society of Anesthesiologist (ASA) physical status class, Mallampati score, comorbidities, sedation medication, sedation time, and complication. A logistic regression was performed assessing risk factors for complications. Statistical significance was assessed at P < 0.05.

Results: There were 1,814 patients included in the study. Median sedation time was 20 minutes. There were 70 (3.9%) total complications. Controlling for age, weight, comorbidities, ASA class, Mallampati score, and total sedation medication, sedation time was a significant predictor of a complication (odds ratio: 1.021; 95% CI, 1.004-1.039).

Conclusions: Pediatric patients can safely undergo procedural sedation in the ED. This study demonstrates a high safety profile for long procedural sedations with slight increases in risk as sedation time increases. There is no identifiable time where the duration of sedation significantly increases the risk of complication.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

References

    1. McDermott K, Stocks C, Freeman W. Overview of Pediatric Emergency Department Visits, 2015. 2015. HCUP Statistical Brief #242. 2018. Rockville, MD: Agency for Healthcare Research and Quality; Available at: www.hcup-us.ahrq.gov/reports/statbriefs/sb242-Pediatric-ED-Visits2015.pdf. Accessed December 18, 2019. - PubMed
    1. Harvey M, Cave G, Betham C. Contemporary sedation practice in a large New Zealand emergency department. NZ Med J. 2011;124:36–45. - PubMed
    1. Cudny ME, Wang NE, Bardas SL, et al. Adverse events associated with procedural sedation in pediatric patients in the emergency department. Hosp Pharm. 2013;48:134–142. - PMC - PubMed
    1. Couloures KG, Beach M, Cravero JP, et al. Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics. 2011;127:e1154–e1160. - PubMed
    1. Coté C, Wilson S. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures: update 2016. Pediatrics. 2016;138:1, 31. - PubMed