+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Evaluation of a pediatric-sedation service for common diagnostic procedures



Evaluation of a pediatric-sedation service for common diagnostic procedures



Academic Emergency Medicine 13(6): 673-676



Pediatric patients often require sedation for diagnostic procedures such as magnetic resonance imaging and computed tomography scanning. In October 2002, a dedicated sedation service was started at a tertiary care pediatric facility as a joint venture between pediatric emergency medicine and pediatric critical care medicine. Before this service, sedation was provided by the department of radiology by using a standard protocol, with high-risk patients and failed sedations referred for general anesthesia. To describe the initial experience with a dedicated pediatric-sedation service. This was a retrospective analysis of quality-assurance data collected on all sedations in the radiology department for 23-month periods before and after sedation-service implementation. Study variables were number and reasons for canceled or incomplete procedures, rates of referral for general anesthesia, rates of hypoxia, prolonged sedation, need for assisted ventilation, apnea, emesis, and paradoxical reaction to medication. Results are reported in odds ratios (OR) with 95% confidence intervals (95% CI). Data from 5,444 sedations were analyzed; 2,148 before and 3,296 after sedation-service activation. Incomplete studies secondary to inadequate sedation decreased, from 2.7% before the service was created to 0.8% in the post-sedation-service period (OR, 0.29; 95% CI = 0.18 to 0.47). There also were decreases in cancellations caused by patient illness (3.8% vs. 0.6%; OR, 0.16; 95% CI = 0.10 to 0.27) and rates of hypoxia (8.8% vs. 4.6%; OR, 0.50; 95% CI = 0.40 to 0.63). There were no significant differences between the groups in rates of apnea, need for assisted ventilation, emesis, or prolonged sedation. The implementation of the sedation service also was associated with a decrease in both the number of patients referred to general anesthesia without a trial of sedation (from 2.1% to 0.1%; OR, 0.33; 95% CI = 0.06 to 1.46) and the total number of general anesthesia cases in the radiology department (from 7.5% to 4.4% of all patients requiring either sedation or anesthesia; OR, 0.56; 95% CI = 0.45 to 0.71). The implementation of a dedicated pediatric-sedation service resulted in fewer incomplete studies related to inadequate sedation, in fewer canceled studies secondary to patient illness, in fewer referrals for general anesthesia, and in fewer recorded instances of sedation-associated hypoxia. These findings have important implications in terms of patient safety and resource utilization.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 048993814

Download citation: RISBibTeXText

PMID: 16670257

DOI: 10.1197/j.aem.2006.01.022


Related references

Office-based deep sedation for pediatric ophthalmologic procedures using a sedation service model. Anesthesiology Research and Practice 2012: 598593, 2012

Sedation in pediatric patients undergoing diagnostic procedures. Drug Intelligence and Clinical Pharmacy 22(9): 711-715, 1988

Pediatric patient sedation and analgesia for diagnostic medical procedures. Rinsho Byori. Japanese Journal of Clinical Pathology 62(8): 775-781, 2014

Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics 118(3): 1087-1096, 2006

The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesthesia and Analgesia 108(3): 795-804, 2009

Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics 89(6 Part 1): 1110-1115, 1992

Guideline for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatric Dentistry 30(7 Suppl.): 143-159, 2009

Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Paediatric Anaesthesia 18(1): 9, 2008

Ambulatory Inotrope Infusions in Advanced Heart Failure: A Systematic Review and Meta-Analysis. Jacc. Heart Failure 6(9): 757-767, 2018

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatric Dentistry 38(4): 13-39, 2016

Guideline for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016. Pediatric Dentistry 38(6): 216-245, 2016

Anesthesia-analgesia vs. deep sedation for diagnostic or therapeutic procedures in pediatric patients: who should perform the technique?. Revista Espanola de Anestesiologia Y Reanimacion 56(4): 203-205, 2009

Pediatric procedural sedation by a dedicated nonanesthesiology pediatric sedation service using propofol. Pediatric Emergency Care 25(3): 133-138, 2009

Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team. Pediatric Radiology 32(7): 505-510, 2002

The safe and effective use of propofol sedation in children undergoing diagnostic and therapeutic procedures: experience in a pediatric ICU and a review of the literature. Pediatric Emergency Care 19(6): 385-392, 2003