Levels of Consciousness and Ventilatory Parameters in Young Children During Sedation With Oral Midazolam and Nitrous Oxide

Litman, Ronald S.; Berkowitz, Robert J.; Ward, Denham S.

doi:10.1001/archpedi.1996.02170320017002

Cited by 67 publications

(24 citation statements)

References 13 publications

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“…52,53 Nitrous oxide has many potential applications, including anxiolysis for procedures such as IV catheter insertion and laceration repair, pain control for burn débridement, and fracture and dislocation reduction; care should be taken if opiates are used concurrently so as not to reduce respiratory drive. 206 The most important part of providing safe sedation for children is the establishment of appropriate sedation systems and sedation training programs with credentialing guidelines for sedation providers that specifically address the core competencies required for the care of pediatric patients. 207,208 Pain Considerations for Children With Developmental Disabilities…”

Section: Analgesia In the Ed And Ems Settingmentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

287

179

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Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child' s and family' s reaction to current and future medical care. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can provide comfort to children in the emergency setting and improve staff and family satisfaction. Pediatrics 2012;130:e1391-e1405 BACKGROUND A systematic approach to pain management is required to ensure relief of pain and anxiety for children who enter into the emergency medical system, which includes all emergency medical services (EMS) agencies, interfacility critical care transport teams, and the emergency department (ED). 1 The administration of appropriate analgesia in children varies by age as well as by training of the ED team (which includes physicians, nurses, physician assistants, and nurse practitioners), however, and still lags behind analgesia provided for adults in similar situations. 2 Furthermore, neonates are at highest risk of receiving inadequate analgesia. 3,4 Encouragingly, improvements in the recognition and treatment of pain in children have led to changes in the approach to pain management for acutely ill and injured pediatric patients. 5 Studies have shown an increase in opiate use in children with fractures. [6][7][8] Recent advances in the approach and support for pediatric analgesia and sedation, as well as new products and devices, have improved the overall climate of the ED for patients and families in search of the "ouchless" ED. 5,9 Increased parental education regarding pain and sedation, physician comfort and desire to enhance patient satisfaction, and a quest to satisfy accreditation regulations have appropriately driven this effort. System-wide approaches for pain management awareness and strategies work best if they are woven into the fabric of the emergency medical system through education and protocol development. The purpose of this report was to provide information to optimize the comfort and minimize the distress of children and families as they are cared for in the emergency setting.

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Section: Analgesia In the Ed And Ems Settingmentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

287

179

View full text Add to dashboard Cite

show abstract

“…In children, midazolam has been combined with inhaled nitrous oxide for sedation and analgesia. However, progression from conscious to deep sedation occurs with nitrous oxide concentrations exceeding 30% (Litman et al, 1996).…”

Section: B Sedation and Ambulatory Anesthesiamentioning

confidence: 99%

Enhancement of GABAergic Activity: Neuropharmacological Effects of Benzodiazepines and Therapeutic Use in Anesthesiology

et al. 2011

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“…Analgesia for more invasive needle procedures, such as lumbar punctures, bone marrow biopsies and aspirates, and central venous line insertions or removals, generally should involve the use of either conscious sedation or general anesthesia. Procedural sedation often is performed safely by oncologists and pediatricians with the use of specific sedation protocols according to the American Academy of Pediatrics guidelines, although considerable controversy remains over several specific aspects of these guidelines [145][146][147][148]. Involvement by pediatric anesthesiologists is recommended for children who are at increased risk or require general anesthesia.…”

Section: Painful Proceduresmentioning

confidence: 99%